ePlasty: Vol. 8
Case Report: Modified Latissimus Dorsi Muscle Transfer for Radial Palsy, Presentation of a New Technique
Shahram Nazerani, MD,a and Mohammad Hosein Kalantar Motamedi, DDSb

aDepartment of Surgery, Iran University of Medical Sciences, Tehran, Iran; and bTrauma Research Center, Baqiyatallah Medical Sciences University, and Attending Faculty, Azad University of Medical Sciences, Tehran, Iran

Correspondence: motamedical@lycos.com

Objective: The latissimus dorsi muscle transfer finger and wrist extension is a well-known procedure for patients needing replantation or in brachial plexus injuries. To increase the length of the transferred muscle to reach to the finger and wrist extensors, the other authors suggest extending the muscle length by incorporating the iliac crest fascia, which not only prolongs the operation time but also minimizes the chances of a healthy and viable muscle-tendon junction. We present a modification of the standard latissimus dorsi transfer whereby the whole muscle (not partial harvest) is transferred and extended by tendon graft to minimize the distal muscle-tendon problems and inefficient muscle excursion commonly encountered with the thus far reported techniques. Methods: In a 12-year period (1996–2008), 5 patients were treated. Guidelines for patient selection were (1) complete high radial nerve palsy with no simpler solution to address the problem, (2) supple joints and gliding tendons, (3) good patient motivation, and (4) free muscle transfer not feasible or risky. Res .......