The free innervated latissimus dorsi flap for functional reconstruction following soft tissue sarcoma resection of the posterior compartment of the thigh

  • Damien Grinsell
  • Zeeshan Ahmad
Original Paper



Soft tissue sarcoma (STS) surgery has evolved significantly over the last half a century. From amputation to limb-salvage and limb-sparing surgery, reconstructive demands have continuously increased in an effort to provide the best function-preserving disease-free outcome. Given STS typically affect the limbs more so than any other region of the body, restoration of function whilst not important oncologically is critical to incorporate in the reconstructive plan of any onco-plastic team. The use of loco-regional flaps as well as free flaps provides the mainstay of reconstructive options. The next advance in the reconstructive journey in this clinical area is the use of innervated flaps to restore function.


Between 2011 and 2016, all patients who  underwent sarcoma extirpation from the  posterior thigh and reconstruction  using a free innervated latissimus dorsi flap were prospectively identified and a  case note review  was performed.


In this series, 7 patients have undergone free flap reconstruction of the thigh posterior compartment achieving MRC (medical research council, UK) grade M5 power restoration in 6/7 patients.


The authors believe this technique to be hugely valuable in the surgical armamentarium of the reconstructive plastic surgeon in order to achieve the best functional outcomes in such a cohort of patients.

Level of Evidence: Level IV, therapeutic study.


Innervated flap Latissimus dorsi Hamstring reconstruction Functional reconstruction Sarcoma reconstruction 


Compliance with ethical standards

Patient consent

All of the patients have given consent.

Conflict of interest

Damien Grinsell and Zeeshan Ahmad declare that they have no conflict of interest.

Ethical approval

Gained from the Local Quality Assurance Sub-committee of the Human Research and Ethics Committee (Reference: QA 057/16).


The authors received no funding in production of this paper.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive SurgerySt Vincents HospitalsMelbourneAustralia

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