TURKISH JOURNAL OF PLASTIC SURGERY, vol.20, no.2, pp.31-33, 2012 (ESCI)
A thirty year old male patient presented to our hand surgery team 2 hours after a motor vehicle accident. His physical examination revealed lack of circulation in his right forearm with totally severed median and ulnar nerves and loss of forearm flexion. Additionally, a 14 x 7 cm skin area was lost. After brachial artery anastomosis with vein graft and median and ulnar nerve coaptation, a functional latissimus dorsi musculo-cutaneous flap was transferred to maintain elbow flexion and defect coverage. However, an excursion problem occurred in the post operative third month. In order to fix this, insertio of the muscle was transferred to a more proximal position. Post operative one year result was satisfactory with the complete flexion of the elbow. This problem appears to occur due to insufficient muscle relaxation during first surgery. In this report the importance of the monitoring anaesthesia and muscle relaxation during this type of functional muscle transfer was stressed to ensure optimum results.