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Evaluation of Shoulder Mobility After Breast Reconstruction With a Lipofilled Latissimus Dorsi Mini-Flap: A
Bruno Carvalho Carelli1, Fabio Bagnoli1, Eduardo de Melo Carvalho Rocha1
1Faculty of Medical Sciences of the Santa Casa de São Paulo, São Paulo, Brazil.
Background:
The lipofilled latissimus dorsi mini-flap (LDMF-L) broadens autologous breast-reconstruction options, yet its functional impact on the shoulder remains uncertain.
Objective:
To evaluate shoulder strength, range of motion (ROM) and patient-reported upper-limb function QuickDash 90 days after breast reconstruction with the LDMF-L.
Methods:
Prospective cohort of 20 patients operated on between November 2022 and November 2024. Inclusion: Breast cancer requiring immediate or delayed reconstruction with LDMF-L; exclusion: Implant use or major pre-existing limitation. Strength (Oxford scale), ROM (goniometry) and QuickDASH score were assessed preoperatively and at 90 days. Wilcoxon, Student's t-test, Mann-Whitney and McNemar tests were used appropriately (α = 0.05).
Results:
Mean age 54 ± 11.8 years; immediate/delayed reconstruction = 50/50%. Strength remained unchanged in 85% (p = 1.000). Active flexion and abduction showed significant reductions (p = 0.016 and 0.045), with no difference in rotations. QuickDASH increased from 8 ± 16 to 19 ± 24 (p = 0.008); nevertheless, 80% stayed within minimal/mild disability.
Conclusions:
The LDMF-L preserves strength and produces only mild early ROM decreases with limited functional impact, supporting its functional safety as an implant-free autologous option.