Does pectoralis major flap harvesting induce upper extremity dysfunction?

Area of Science:

• Reconstructive surgery
• Oncology
• Orthopedics

Background:

• Head and neck cancer resection often requires complex reconstruction.
• Pectoralis major myocutaneous (PMM) flaps are utilized for reconstruction.
• The impact of PMM flaps on upper extremity function requires evaluation.

Purpose of the Study:

• To assess the effect of PMM flap reconstruction on upper extremity dysfunction.
• To compare functional outcomes between PMM flap and non-PMM flap reconstructions.

Main Methods:

• Patients undergoing PMM flap reconstruction for head and neck cancer were studied.
• A control group received non-PMM flap reconstruction, matched for age, sex, and clinical characteristics.
• The Disability of the Arm, Shoulder, and Hand (DASH) questionnaire was administered preoperatively and >1 year postoperatively.

Main Results:

• No significant change in DASH scores was observed in the control group.
• The PMM flap group showed a significant increase in postoperative DASH scores compared to preoperative.
• Flap size correlated with increased postoperative upper extremity dysfunction in the PMM group.

Conclusions:

• PMM flap reconstruction results in a statistically significant, albeit small, negative impact on upper extremity function.
• This finding highlights a potential trade-off between oncologic reconstruction and functional preservation.