Article (Scientific journals)
Shoulder function after latissimus dorsi transfer in breast reconstruction
Forthomme, Bénédicte; Heymans, Olivier; Jacquemin, Denise et al.
2010In Clinical Physiology and Functional Imaging, 30 (6), p. 406-412
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Keywords :
imbalances; isokinetic assessment; latissimus dorsi transfer; muscle strength; shoulder
Abstract :
[en] Background ⁄ Aims: Latissimus dorsi (LD) transfer in the case of breast reconstruction remains frequently used because this muscle provides a good size source of tissue in reconstructive surgery. Given that, the consequences of the LD removal on shoulder function and the actual loss of maximal strength developed must be investigated. Methods: Twenty women (50 ± 7Æ5 years old) were evaluated before surgery, 3 and 6 months after an unilateral transfer of a pedicle flap of LD muscle used for breast reconstruction. Women performed a bilateral shoulder isokinetic assessment [for the internal rotators (IRs) and external rotators and for the abductor and adductor (ADD) muscles] allowing the establishment of bilateral muscular deficit status and the study of agonist ⁄ antagonist muscle ratios. The algofunctional and clinical status of the shoulders was analysed by the means of Constant score and specific shoulder clinical tests. The women did not perform any specific strengthening of muscle shoulder after surgery. Results: The isokinetic assessment showed a muscle weakness 3 and 6 months after LD transfer, mainly on the ADDs (33 ± 9% at 6 months) and on the IRs (16 ± 11% at 6 months). The Constant score significantly decreased after surgery on the operated shoulder. Women with a Constant score impairment showed pain during specific shoulder clinical tests. We also found a correlation between Constant score impairment and internal rotators weakness or rotator muscle imbalance. Conclusion: Given those results, we could advocate a specific shoulder strengthening after LD transfer, focused mainly on the IRs and ADDs.
Disciplines :
Surgery
Laboratory medicine & medical technology
Orthopedics, rehabilitation & sports medicine
Author, co-author :
Forthomme, Bénédicte ;  Université de Liège - ULiège > Département des sciences de la motricité > Rééducation du membre supérieur
Heymans, Olivier;  Centre Hospitalier Universitaire de Liège - CHU > Service de Chirurgie maxillo-faciale et plastique
Jacquemin, Denise ;  Université de Liège - ULiège > Chirurgie maxillo-faciale et plastique
Klinkenberg, Sandrine
Hoffmann, Sandy
Grandjean, François-Xavier ;  Université de Liège - ULiège > Imagerie médicale
Crielaard, Jean-Michel ;  Université de Liège - ULiège > Département des sciences de la motricité > Evaluation et entraînement des aptitudes physiques - Médecine physique et réadaptation fonctionnelle
Croisier, Jean-Louis ;  Université de Liège - ULiège > Département des sciences de la motricité > Kinésithérapie générale et réadaptation
Language :
English
Title :
Shoulder function after latissimus dorsi transfer in breast reconstruction
Publication date :
November 2010
Journal title :
Clinical Physiology and Functional Imaging
ISSN :
1475-0961
eISSN :
1475-097X
Publisher :
Wiley
Volume :
30
Issue :
6
Pages :
406-412
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 05 August 2010

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