title: A Prospective Analysis on Functional Outcomes Following Extended Latissimus Dorsi Flap Breast Reconstruction.
abstract: BACKGROUND
  To prospectively assess the functional effect of using the extended latissimus dorsi flap in immediate breast reconstructions.
  
  
  METHODS
  A total of 15 consecutive patients undergoing breast reconstruction with extended latissimus dorsi flap participated. Shoulder range of motion, muscle strength, lateral flexion of the torso, and position of scapula were measured pre-operatively and 1, 6, and 12 months post-operatively, in addition to donor-site post-operative complications.
  
  
  RESULTS
  At 12 months post-operatively, patients had achieved full range of shoulder movement, when compared to pre-operative values. Lateral flexion of the torso was, however, significantly reduced bilaterally at 1 and 6 months post-operatively (p = 0.001, p = 0.01) and to the not operated side at 12 months (p = 0.01). Muscle strength in flexion-extension-internal rotation was significantly (p = 0.01) reduced on the operated side 12 months post-operatively. All but one patient had numbness around the donor-site scar 12 months post-operatively, 33% had slight adhesions but all were pain free.
  
  
  CONCLUSIONS
  Although invariably, patients having extended latissimus dorsi flap may expect to achieve full range of shoulder movement, they should be informed of possible functional consequences and the time and effort it takes to recover. Further research is needed to investigate the potential long-term functional implications that extended latissimus dorsi flap may have as a result of changes in the lateral flexion of the torso and scapula position.
authors.affiliation: 1 Department of Physiotherapy, Landspitali-The National University Hospital, Reykjavik, Iceland.
authors.forename: H
authors.initials: H
authors.lastname: Eyjolfsdottir
authors.affiliation: 1 Department of Physiotherapy, Landspitali-The National University Hospital, Reykjavik, Iceland.
authors.forename: B
authors.initials: B
authors.lastname: Haraldsdottir
authors.affiliation: 1 Department of Physiotherapy, Landspitali-The National University Hospital, Reykjavik, Iceland.
authors.forename: M
authors.initials: M
authors.lastname: Ragnarsdottir
authors.affiliation: 2 Department of Surgery, Landspitali-The National University Hospital, Reykjavik, Iceland.
authors.forename: K S
authors.initials: KS
authors.lastname: Asgeirsson
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012785:Shoulder Joint / Q000503:physiopathology; D064171:Superficial Back Muscles / Q000601:surgery* / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: Breast reconstruction; extended autologous latissimus dorsi flap; mastectomy; oncoplastic breast surgery