Impairment of the brachial plexus after harvest of the latissimus dorsi muscle for reanimation of a paralysed face

We describe the technique of transferring the latissmus dorsi muscle as an island flap for the restoration of digital flexion or extension in 28 patients. The latissmus dorsi muscle is raised down to the posterior iliac crest and prolonged with the gluteal superficial facia. We believe that this method is particularly suitable for extensive and prolonged paralysis of the lower elements of brachial plexus. It can be used also for severe Volkmann’s contracture or the loss of flexor or extensor muscles of the fingers due to extensive debridement. The technique does not require microsurgery and there is no delay in reinnervation of the muscle.

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Reconstruction of hook grip function of the fingers in patients with traumatic brachial plexus injury

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211054968 ◽

2021 ◽

pp. 175319342110549

Author(s):

Yuki Hara ◽

Yasumasa Nishiura ◽

Yuichi Yoshii ◽

Shunsuke Asakawa ◽

Yukei Matsumoto ◽

...

Keyword(s):

Brachial Plexus ◽

Latissimus Dorsi ◽

Brachial Plexus Injury ◽

Hand Function ◽

Latissimus Dorsi Muscle ◽

Flexor Digitorum Profundus ◽

Reconstruction Method ◽

Level Of Evidence ◽

Pedicle Flap ◽

Dorsi Muscle

We described a reconstruction method for restoring hook grip function of the fingers in patients with total brachial plexus injury. The paralysed latissimus dorsi muscle was transferred to the upper limb as a pedicle flap and sutured to the flexor digitorum profundus tendons. The muscle was then reanimated with two intercostal donor nerves to the thoraco-dorsal nerve. Fourteen young adult patients (mean 23 years, range 17 to 32 years) with traumatic brachial plexus injury who underwent reconstruction using this technique from 2000 to 2019. After mean follow-up of 65 months (range 20 to 170), finger flexion of strength greater than or equal to M3 was achieved in 10 of the 14 patients. The mean weight that could be lifted using a hook grip was 2.6 kg, and that which could be lifted with both hands was 4.1 kg. The intercostal nerve-innervated latissimus dorsi muscle transfer can provide useful hook grip hand function without the need to sacrifice donor vessels or healthy muscles. Level of evidence: IV

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Latissimus dorsi muscle transfer for restoration of elbow flexion after brachial plexus disruption

The Journal Of Hand Surgery ◽

10.1016/s0363-5023(86)80121-6 ◽

1986 ◽

Vol 11 (1) ◽

pp. 135-139 ◽

Cited By ~ 43

Author(s):

Moheb S. Moneim ◽

George E. Omer

Keyword(s):

Brachial Plexus ◽

Latissimus Dorsi ◽

Elbow Flexion ◽

Latissimus Dorsi Muscle ◽

Muscle Transfer ◽

Dorsi Muscle

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Shoulder Functional Outcome after Latissimus Dorsi Muscle Transfer and Subscapularis Muscle Release in Children with Obstetrical Brachial Plexus Palsy

Journal of the Royal Medical Services ◽

10.12816/0011367 ◽

2015 ◽

Vol 22 (2) ◽

pp. 45-50

Author(s):

Firas A. Suleiman ◽

Razi Y. Tarawneh ◽

Mahmoud Al-Anani

Keyword(s):

Brachial Plexus ◽

Functional Outcome ◽

Latissimus Dorsi ◽

Latissimus Dorsi Muscle ◽

Brachial Plexus Palsy ◽

Muscle Transfer ◽

Subscapularis Muscle ◽

Obstetrical Brachial Plexus Palsy ◽

Dorsi Muscle

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Latissimus Dorsi Transplantation to Restore Elbow Flexion to the Paralysed Limb

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(84)90017-2 ◽

1984 ◽

Vol 9 (1) ◽

pp. 61-63 ◽

Cited By ~ 10

Author(s):

H. TAKAMI ◽

S. TAKAHASHI ◽

M. ANDO

Keyword(s):

Brachial Plexus ◽

Latissimus Dorsi ◽

Elbow Flexion ◽

Latissimus Dorsi Muscle ◽

Elbow Flexor ◽

Dorsi Muscle ◽

Neurovascular Pedicle

In two patients with flexor paralysis of the elbow due to a lesion of the brachial pluxus, the entire latissimus dorsi muscle was transplanted to act as an elbow flexor, preserving its neurovascular pedicle. This flexorplasty proved useful for patients who had suffered a traction lesion of the upper trunk of the brachial plexus.

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