Evaluation of Shoulder Mobility After Breast Reconstruction With a Lipofilled Latissimus Dorsi Mini-Flap: A Prospective Cohort Study.

BACKGROUND

The lipofilled latissimus dorsi mini-flap (LDMF-L) broadens autologous breast-reconstruction options, yet its functional impact on the shoulder remains uncertain.

OBJECTIVE

To evaluate shoulder strength, range of motion (ROM) and patient-reported upper-limb function QuickDash 90 days after breast reconstruction with the LDMF-L.

METHODS

Prospective cohort of 20 patients operated on between November 2022 and November 2024. Inclusion: Breast cancer requiring immediate or delayed reconstruction with LDMF-L; exclusion: Implant use or major pre-existing limitation. Strength (Oxford scale), ROM (goniometry) and QuickDASH score were assessed preoperatively and at 90 days. Wilcoxon, Student's t-test, Mann-Whitney and McNemar tests were used appropriately (α = 0.05).

RESULTS

Mean age 54 ± 11.8 years; immediate/delayed reconstruction = 50/50%. Strength remained unchanged in 85% (p = 1.000). Active flexion and abduction showed significant reductions (p = 0.016 and 0.045), with no difference in rotations. QuickDASH increased from 8 ± 16 to 19 ± 24 (p = 0.008); nevertheless, 80% stayed within minimal/mild disability.

CONCLUSIONS

The LDMF-L preserves strength and produces only mild early ROM decreases with limited functional impact, supporting its functional safety as an implant-free autologous option.