Oda Sachie, Okochi Masayuki, Komuro Yuzo, Soejima Naoto
From the Department of Plastic and Reconstructive Surgery, Teikyo University, Itabashi, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2024 Dec 18;12(12):e6387. doi: 10.1097/GOX.0000000000006387. eCollection 2024 Dec.
Elbow flexion is essential for the functional use of the hand. The reconstructive procedure may also change depending on the location of the sarcoma. The nonresected muscle may alter the function of the elbow. If the proximal part of the triceps muscle remains intact, it is considered functional. Functional muscle transfer is not required in such cases. A 50-year-old patient presented with a soft-tissue defect after a wide resection of a leiomyosarcoma affecting the left elbow. The wide resection resulted in the resection of the distal third of the triceps brachii, exposing the olecranon. We performed reconstruction using a pedicled latissimus dorsi musculocutaneous flap. The flap was transferred to the elbow through a subcutaneous tunnel. Ten months after surgery, the elbow function improved. In our patient, the thoracodorsal nerve was cut to prevent mixed nerve signals. We found that patients with distal muscle defects do not require functional muscle grafting. Pedicled latissimus dorsi musculocutaneous flap transfer is a straightforward and useful procedure for reconstructing the upper arm region.
肘关节屈曲对于手部的功能使用至关重要。重建手术也可能因肉瘤的位置而有所不同。未切除的肌肉可能会改变肘关节的功能。如果肱三头肌近端保持完整,则认为其功能正常。在这种情况下不需要进行功能性肌肉转移。一名50岁患者在广泛切除累及左肘关节的平滑肌肉瘤后出现软组织缺损。广泛切除导致肱三头肌远端三分之一被切除,尺骨鹰嘴暴露。我们使用带蒂背阔肌肌皮瓣进行重建。该皮瓣通过皮下隧道转移至肘部。术后十个月,肘关节功能有所改善。在我们的患者中,切断了胸背神经以防止混合神经信号。我们发现,远端肌肉缺损的患者不需要进行功能性肌肉移植。带蒂背阔肌肌皮瓣转移是一种用于重建上臂区域的直接且有用的手术方法。