Pedicled Unipolar Latissimus Dorsi Flap for Functional Reconstruction of Finger Extension

Abstract

The latissimus dorsi muscle can be used for functional reconstruction and as a musculocutaneous flap to cover a large soft tissue defect. We describe application of a pedicled unipolar latissimus dorsi flap to reconstruct finger extension. The patient had massive defects in the radial nerve and extensor musculature as well as weakness of the flexor muscles due to a crush and de-gloving injury at the elbow. As a result, finger extension could not be restored by local tendon transfer. In harvesting the latissimus dorsi, we continued the dissection down to the gluteal fascia and across the periosteum on the iliac crest. A 50-cm-length latissimus dorsi flap was prepared, which enabled the fascial end of the flap to be sutured to the tendinous portion of the extensor digitorum without overstretching. A pedicled unipolar latissimus dorsi flap does not require a microsurgical procedure, which may promote early functional recovery.