Bipolar latissimus dorsi flap transfer for reconstruction of the deltoid.

Four patients with complete paralysis of the deltoid muscle with irrepairable axillary nerve lesion and one with traumatic destruction of the shoulder cap were treated with a bipolar latissimus dorsi muscle transfer. The latissimus dorsi muscle was prepared as an island flap, turned over and sutured to the trapezius proximally and to the original deltoid insertion on the humerus distally. Function and cosmesis were excellent in two patients; in one case the goal was only to achieve soft-tissue coverage, and was successfully achieved. One patient only had partial survival of the muscle and in one case the procedure failed to restore active functional abduction.