Minami A, Ogino T, Ohnishi N, Itoga H
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Clin Orthop Relat Res. 1990 Nov(260):201-6.
The latissimus dorsi was transferred as a pedicle flap in ten patients and as a free vascular flap in ten others for extremity reconstruction. Group I comprised ten patients in whom the transfer was used solely to cover a skin or soft-tissue defect. Although there was partial necrosis of the transferred skin in one patient, the remaining nine patients obtained complete coverage without further reconstructive surgery. Group II comprised five patients in whom transfer of the latissimus dorsi was performed for active flexion or extension of the elbow or for abduction of the shoulder. Postoperatively, muscle strength obtained was classified from Grades 0 to 5 according to the muscle testing method. Three patients obtained muscle strength of Grade 3, while two obtained Grade 2. Group III comprised five patients who had brachial plexus palsy after high-dose irradiation. Coverage of the skin and soft tissue was performed after neurolysis of the brachial plexus palsy to free the tissue bed of scarred tissue. Postoperatively, sensory and motor disturbances were alleviated in four of five patients.
在10例患者中，背阔肌被作为带蒂皮瓣转移，在另外10例患者中作为游离血管皮瓣用于肢体重建。第一组包括10例患者，转移仅用于覆盖皮肤或软组织缺损。虽然有1例患者转移的皮肤出现部分坏死，但其余9例患者无需进一步重建手术即可获得完全覆盖。第二组包括5例患者，行背阔肌转移以实现肘部的主动屈伸或肩部外展。术后，根据肌肉测试方法，获得的肌力从0级到5级进行分级。3例患者获得3级肌力，2例获得2级肌力。第三组包括5例在高剂量放疗后出现臂丛神经麻痹的患者。在对臂丛神经麻痹进行神经松解以松解瘢痕组织的组织床后，进行皮肤和软组织覆盖。术后，5例患者中有4例感觉和运动障碍得到缓解。
