Functioning free latissimus dorsi muscle transplantation: anterogradely positioned usage in reconstruction of extensive forearm defect.

We present a patient with successful functional recovery of a severely injured upper extremity after a microneurovascular free latissimus dorsi muscle and combined composite skin were transplanted with an anterograde position. In our patient, the anterogradely positioned usage of the lastissimus muscle offered two major advantages; one advantage was the direct anastomosis of a more proximal healthy uninjured recipient nerve without interpositional nerve graft, and the other, one-stage coverage including the elbow wound with combined scapular skin flap. From our result, we deduce that a neurovascular free latissimus dorsi muscle transplantation with an anterograde position is selectively indicated in functional recovery of an extensively injured forearm.