Functional evaluation of donor side morbidity after free latissimus dorsi flep

Objective: Latissimus dorsi free flap is one of the flap options that is being frequently used in the reconstructive microsurgery to close the wide tissue defects with a safe pedicle. However, there are not enough studies with regard to long-term functional morbidity in the existing literature. The aim of this study was to compare the long-term functional results with the isokinetic muscle strength measurement, which is a more sensitive test method than the traditional methods, in order to evaluate the muscle functions. Patients and methods: Fifteen (15) patients who were preferred LD flaps for the reconstruction in our Clinic were included in this study. Isokinetic muscle strength measurements and ROM measurements were conducted to the selected patients in the 6th month of the post-operative period. At the same time, the quality of life and daily vital activities in patients were evaluated with the arm, shoulder and hand disability (DASH) questionnaire and Constant shoulder score test. Then, the quality of life and daily activity scales were analyzed with biomechanical parameters obtained from objective data. Results: The results demonstrated that there is a significant decrease in adduction and extension muscle strengths in the 6th month of the post-operative period (p <0.05). Even though quick DASH and Constant shoulder scores have fallen substantially (p <0.05) in a statistical way, the results did not reach the size to affect daily life functions. In addition, there is a partial decrease in internal rotation, external rotation and abduction joint range of motion in the measurements. No correlation was found between muscle strength measurements and Constant and Dash scores (p> 0.05). Conclusion: This study found that there is not any negative change in the quality of life of patient after latissimus dorsi flap in the 6th month of the post-operative period. It was also observed that the patient can continue their daily vital activities related to the upper limb just like before the operation. Overall, this study reveals that there is a considerable decrease in adduction and extension muscle strength, nevertheless it has no effect on the patient's daily vital activities. Keywords: Latissimus dorsi, free flap, muscle strength measurement