Functional latissimus dorsi island pedicle musculocutaneous flap to restore finger function

Functional latissimus dorsi island pedicle musculocutaneous flaps were used to restore flexion or extension of the wrist and digits in four clinical cases. By retaining the fascial origin of the latissimus dorsi from the posterior crest of the ilium, the entire muscle was transferred without dividing its neurovascular pedicle and microneurovascular anastomoses. Its facial origin successfully reached the finger flexor or extensor muscles of the forearm. The latissimus dorsi muscle was sutured to the digital flexor tendons in three patients and connected to the extensor tendons in one patient. All transfers restored active finger flexion or extension.