The latissimus dorsi muscle: a fresh cadaver study of the primary neurovascular pedicle.

The primary neurovascular pedicle of the latissimus dorsi muscle was studied in 50 fresh cadaver dissections and pertinent dimensions and anatomic relations was recorded. Some findings applicable to clinical reconstructive surgery are: 1. Vascular pedicle of 11 cm mean length (subscapular-thoracodorsal artery and vein). 2. Consistent T-shaped relationship among subscapular artery, thoracodorsal artery, circumflex scapular artery, and serratus arterial branch(es). 3. Large serratus anterior branch(es) from the thoracodorsal artery (1.1 mm mean diameter). 4. Consistent posterior location of neurovascular hilus at muscle junction. 5. Bifurcation of neurovascular structures at the hilus into superior and lateral intramuscular bundles (86 percent of dissections), making various surgical options with the latissimus dorsi skin-muscle flap possible. 6. Lengthy thoracodorsal nerve (12.3 cm mean length). 7. Low incidence of atherosclerosis in the subscapular artery (8 percent) and no significant atherosclerosis seen in the thoracodorsal artery.