Effect of latissimus dorsi flap breast reconstruction on the strength profile of the upper extremity

Martine A. van Huizum, Marije J. Hoornweg, Noor de Ruiter, Erik Oudenhoven, J. Joris Hage, Dirk Jan Veeger

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Abstract: Objective: Dissection of the latissimus dorsi (LD) flap may have a distinct impact on upper extremity function and strength. To date, insufficient differentiation has been made between loss of muscular strength and shoulder function by dissection of the LD muscle per se and loss of function resulting from all excisional surgery, radiation therapy, and reconstructive procedures at the donor site and the recipient site that may have been combined near the shoulder region. Methods: This study determines the long-term effect of the LD breast reconstruction on the strength profiles of the upper extremity by measuring the isometric torque strength both in seven synergistic- and two contra-movement directions. The Biodex System 3 Pro (Biodex Medical Systems, New York, NY) was used in 12 patients at a mean of 3.5 years after surgery, and in 20 matched controls. Because loss of LD muscle may not result in significant impairment of activities of daily live (ADL) even in cases where objective measurements are decreased, this study simultaneously assessed the subjective function by use of the standardised Disability of Arm, Shoulder and Hand (DASH) questionnaire. Results: This study observed a significant long-term loss of 8.8 Nm or 19% LD torque strength in synergistic movement directions after transplantation of the LD muscle. This loss correlated significantly with an increase of the mean DASH score among the patients. Conclusions: Because no significant loss of contra-movement torque strength was observed, it was concluded that the loss of synergistic torque strength appears to result from the loss of LD function per se.

Original languageEnglish
Pages (from-to)202-207
Number of pages6
JournalJournal of Plastic Surgery and Hand Surgery
Volume50
Issue number4
DOIs
Publication statusPublished - 3 Jul 2016

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Superficial Back Muscles
Mammaplasty
Upper Extremity
Torque
Muscles
Dissection
Arm
Hand
Radiotherapy
Transplantation
Tissue Donors

Keywords

  • breast reconstruction
  • DASH score
  • Latissimus dorsi muscle
  • muscular torque strength

Cite this

van Huizum, Martine A. ; Hoornweg, Marije J. ; de Ruiter, Noor ; Oudenhoven, Erik ; Hage, J. Joris ; Veeger, Dirk Jan. / Effect of latissimus dorsi flap breast reconstruction on the strength profile of the upper extremity. In: Journal of Plastic Surgery and Hand Surgery. 2016 ; Vol. 50, No. 4. pp. 202-207.
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abstract = "Abstract: Objective: Dissection of the latissimus dorsi (LD) flap may have a distinct impact on upper extremity function and strength. To date, insufficient differentiation has been made between loss of muscular strength and shoulder function by dissection of the LD muscle per se and loss of function resulting from all excisional surgery, radiation therapy, and reconstructive procedures at the donor site and the recipient site that may have been combined near the shoulder region. Methods: This study determines the long-term effect of the LD breast reconstruction on the strength profiles of the upper extremity by measuring the isometric torque strength both in seven synergistic- and two contra-movement directions. The Biodex System 3 Pro (Biodex Medical Systems, New York, NY) was used in 12 patients at a mean of 3.5 years after surgery, and in 20 matched controls. Because loss of LD muscle may not result in significant impairment of activities of daily live (ADL) even in cases where objective measurements are decreased, this study simultaneously assessed the subjective function by use of the standardised Disability of Arm, Shoulder and Hand (DASH) questionnaire. Results: This study observed a significant long-term loss of 8.8 Nm or 19{\%} LD torque strength in synergistic movement directions after transplantation of the LD muscle. This loss correlated significantly with an increase of the mean DASH score among the patients. Conclusions: Because no significant loss of contra-movement torque strength was observed, it was concluded that the loss of synergistic torque strength appears to result from the loss of LD function per se.",
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Effect of latissimus dorsi flap breast reconstruction on the strength profile of the upper extremity. / van Huizum, Martine A.; Hoornweg, Marije J.; de Ruiter, Noor; Oudenhoven, Erik; Hage, J. Joris; Veeger, Dirk Jan.

In: Journal of Plastic Surgery and Hand Surgery, Vol. 50, No. 4, 03.07.2016, p. 202-207.

Research output: Contribution to JournalArticleAcademicpeer-review

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AU - van Huizum, Martine A.

AU - Hoornweg, Marije J.

AU - de Ruiter, Noor

AU - Oudenhoven, Erik

AU - Hage, J. Joris

AU - Veeger, Dirk Jan

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N2 - Abstract: Objective: Dissection of the latissimus dorsi (LD) flap may have a distinct impact on upper extremity function and strength. To date, insufficient differentiation has been made between loss of muscular strength and shoulder function by dissection of the LD muscle per se and loss of function resulting from all excisional surgery, radiation therapy, and reconstructive procedures at the donor site and the recipient site that may have been combined near the shoulder region. Methods: This study determines the long-term effect of the LD breast reconstruction on the strength profiles of the upper extremity by measuring the isometric torque strength both in seven synergistic- and two contra-movement directions. The Biodex System 3 Pro (Biodex Medical Systems, New York, NY) was used in 12 patients at a mean of 3.5 years after surgery, and in 20 matched controls. Because loss of LD muscle may not result in significant impairment of activities of daily live (ADL) even in cases where objective measurements are decreased, this study simultaneously assessed the subjective function by use of the standardised Disability of Arm, Shoulder and Hand (DASH) questionnaire. Results: This study observed a significant long-term loss of 8.8 Nm or 19% LD torque strength in synergistic movement directions after transplantation of the LD muscle. This loss correlated significantly with an increase of the mean DASH score among the patients. Conclusions: Because no significant loss of contra-movement torque strength was observed, it was concluded that the loss of synergistic torque strength appears to result from the loss of LD function per se.

AB - Abstract: Objective: Dissection of the latissimus dorsi (LD) flap may have a distinct impact on upper extremity function and strength. To date, insufficient differentiation has been made between loss of muscular strength and shoulder function by dissection of the LD muscle per se and loss of function resulting from all excisional surgery, radiation therapy, and reconstructive procedures at the donor site and the recipient site that may have been combined near the shoulder region. Methods: This study determines the long-term effect of the LD breast reconstruction on the strength profiles of the upper extremity by measuring the isometric torque strength both in seven synergistic- and two contra-movement directions. The Biodex System 3 Pro (Biodex Medical Systems, New York, NY) was used in 12 patients at a mean of 3.5 years after surgery, and in 20 matched controls. Because loss of LD muscle may not result in significant impairment of activities of daily live (ADL) even in cases where objective measurements are decreased, this study simultaneously assessed the subjective function by use of the standardised Disability of Arm, Shoulder and Hand (DASH) questionnaire. Results: This study observed a significant long-term loss of 8.8 Nm or 19% LD torque strength in synergistic movement directions after transplantation of the LD muscle. This loss correlated significantly with an increase of the mean DASH score among the patients. Conclusions: Because no significant loss of contra-movement torque strength was observed, it was concluded that the loss of synergistic torque strength appears to result from the loss of LD function per se.

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