Functional assessment of the shoulder following latissimus dorsi muscle donation in the handicapped.

The latissimus dorsi muscle, one of the largest muscles in the human body, has gained widespread popularity in microsurgical reconstruction. Because the latissimus serves to adduct and medially rotate the upper extremity, caution in its use has been advocated in handicapped and non-ambulatory patients, although a paucity of information exists in the literature. The purpose of this reported project was to determine whether the loss of the latissimus dorsi could be documented objectively or subjectively, either in the preoperative condition or post-harvesting in the handicapped patients. Two paraplegic patients were studied. Results indicate a lack of objective functional deficit; this includes both the nerve-blocked state and the postoperative condition. In addition, both patients failed to demonstrate the need to change any activities of daily living. This evidence suggests that, although careful decisions must be made on a case-by-case basis, the use of the latissimus dorsi muscle is not necessarily contraindicated in this group of patients.