Reconstruction of the Triceps Brachii Using the Latissimus Dorsi Musculocutaneous Flap

Abstract

Elbow flexion is essential for the functional use of the hand. The reconstructive procedure may also change depending on the location of the sarcoma. The nonresected muscle may alter the function of the elbow. If the proximal part of the triceps muscle remains intact, it is considered functional. Functional muscle transfer is not required in such cases. A 50-year-old patient presented with a soft-tissue defect after a wide resection of a leiomyosarcoma affecting the left elbow. The wide resection resulted in the resection of the distal third of the triceps brachii, exposing the olecranon. We performed reconstruction using a pedicled latissimus dorsi musculocutaneous flap. The flap was transferred to the elbow through a subcutaneous tunnel. Ten months after surgery, the elbow function improved. In our patient, the thoracodorsal nerve was cut to prevent mixed nerve signals. We found that patients with distal muscle defects do not require functional muscle grafting. Pedicled latissimus dorsi musculocutaneous flap transfer is a straightforward and useful procedure for reconstructing the upper arm region.

Fig. 1.

Postoperative view of the elbow after tumor resection at the distal third of the triceps brachii.

Fig. 2.

The harvested flap from the anterior border of the latissimus dorsi muscle.

Fig. 3.

Active extension of the elbow, demonstrating the full functional capacity of the triceps brachii muscle.

Fig. 4.

Elbow joint performing an active flexion movement.