The function of the shoulder after removal of the vascularized
latissimus dorsi muscle in seventeen patients was compared with the
function of the shoulder in seventeen control subjects. Physical
examination of the extremity and instrumented muscle-testing were used to
evaluate both the patients and the control subjects, and the patients also
completed a questionnaire. Thirteen patients rated the appearance of the
donor extremity as good, and sixteen patients perceived no functional
impairment of the donor extremity. The range of motion of both shoulders
was symmetrical in eleven patients and fourteen control subjects. Manual
muscle-testing showed normal strength of the latissimus dorsi bilaterally
in seven patients and in thirteen control subjects. Nineteen instrumented
isometric, isotonic, and isokinetic tests were performed to assess the
strength of each shoulder of all of the patients and control subjects, and
the results in these two groups were then compared. there was no
statistically significant difference in the strength of the two shoulders
between the patients and the control subjects, with the exception that the
patients exhibited weakness in the amount of isokinetic torque during
extension of the shoulder with the limb in a position of 60 degrees of
flexion and at a speed of 60 degrees per second. On the basis of these
findings, and because of the inherent inaccuracy of manual muscle-testing,
we concluded that transfer of the vascularized latissimus dorsi muscle had
little effect on the range of motion, muscular strength, and function of
the donor shoulder in our patients.