Shoulder function following the loss of the latissimus dorsi muscle.

A study of shoulder function was carried out in a group of 19 male patients who had their latissimus dorsi muscle removed as a free flap. A control group was examined to obtain data for the normal range of movement and power at the shoulder. Only a few patients had any subjective impairment of shoulder function; 13 of our 19 patients had a complete range of movement at the shoulder. There was no significant difference in power between the patient group and the control group when dominant and non-dominant sides were considered separately (p greater than 0.05). Patients who had surgery carried out more recently and patients with a scar contracture had a significantly higher disability score. The latter group also had a greater deficit in range of movement at the shoulder (p less than 0.05). Most patients encountered no difficulty whatever with their occupational and sporting activities. Our results support the view that the latissimus dorsi muscle is totally expendable and that there is no significant functional loss at the shoulder, either in casual or in forceful activities.