Reconstruction of hip abduction using free muscle transplantation: a case report and description of the technique.

The authors describe a free-functioning latissimus dorsi muscle transplantation for reconstruction of hip abduction. A radical "buttockectomy" was performed on a 62-year-old patient with recurrent soft-tissue sarcoma. The patient received a muscle transplantation immediately after resection of the tumor. Until recovery of the muscle, a complete absence of hip abductors resulted in a marked lurch in the patient's gait, requiring him to use walking aids. Reinnervation of the muscle was confirmed via electromyography 6 months after surgery. Hip abduction was restored along with muscle recovery, and walking support was no longer required. Although the strength of the muscle was not sufficiently powerful to overcome gravity fully, the latissimus dorsi muscle improved markedly the performance of an otherwise unstable hip. This patient demonstrates that microsurgical reconstruction is of great value in enhancing the functional outcome of a salvaged limb after tumor surgery.