You mean Removing an Important Shoulder Muscle Impacts the Shoulder? Who Knew?

POSTED ON 12/30/2011 IN Shoulder BY Christopher Centeno

free flap surgery
The Latissimus Dorsi is a very important shoulder girdle muscle that you may know because it helps give your chin-ups power. The "lat" muscle is also the main muscular connector between your upper body and the lower back which also acts to keep the shoulder ball aligned in the socket. At the same time, the muscle has been used for many years as a "free flap" by surgeons. A free flap is a piece of tissue (usually muscle) with a good blood supply that can be moved to another area without a blood supply or that needs filling. It's also been assumed that moving the lat muscle for a free flap surgery had little consequences, but a new study has shown otherwise. This is small study of 8 patients who underwent free flap surgery using their lat muscles about 5-10 years earlier (mean of about 7 years). They were then given standardized shoulder questionnaires comparing the operated shoulders to the non-operated side. The side with the free flap surgery had poorer function and range of motion as well as more instability. There was also less strength on the operated side. The upshot? There is no free lunch or "free flap" without consequences. These biomechanical consequences need to be a part of our physician educational system and the importance of them needs to be taught to patients. As a result, our book Orthopedics 2.0 was written to educate patients about how an basic understanding of biomechanics needs to be part of any orthopedic diagnosis.
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