Latissimus Dorsi..."fans Your Face", Lifts Your Bust, "scratches Your Back"!
To The Lay Reader:
Visualize a queenly hand fan. Visualize this fan to be automated.
Visualize the tip of its handle (its pedicle) to be glued to the inner surface of the upper part of your upper arm.
Visualize this automated fan spread spontaneously of its own accord to scratch your upper back on that side.
Visualize this fan yet again, close its wing, swing under your armpit around its pedicle acting as a folcrum or pivot in a forward direction!
Visualize it again to spread open (its wing) as it now braces up to serve the frontal part of your body!
In your mind's eye, see this open fan, still tethered with its pedicle to your inner arm "fan" your face, your upper arm down to your elbow, your chest and your upper abdomen!
In truth, it in reality, does much more than fan your face. It can be mobilized in solo- or my-cutaneous pedicle flaps to:
...lift up your bust...if they had been previously surgically removed...added fillers like breast implants a welcome addition to the props...
...patch up your anterior upper abdominal wall...
...patch up the pariete of your skull...
...patch up your elbow in flexion deformities!
With that short epistle, I have summed up the miracle to which our brilliant surgeons have put this weird-sounding flat fan-like muscle in the back... to use. One on each side...
Now I admonish you to stop here if you are not a doctor!
As I would not be held responsible if you were to develop a headache!
LATISSIMUS DORSI FLAP
May be an isolated muscle flap or a myocutaneous flap that carries the covering skin along with the underlying muscle.
Designed like the local fan, its origins are multifarous...iliac crest, lumbosacral (lumbodorsal) fascia, the supraspinal ligament, inferior edge of the scapula, the spines of lower 6 thoracic vertebrae, the sacrum and the lowest 4 ribs.
All its fibres however converge at the superio-medial edge of the scapula to insert on the lesser tubercle of the humerus just posterior to the insertion of teres major.
This "insertion" end of the muscle is used as its folcrum of rotation in pedicle flaps that carry as much of its neuro-vascular bundle along with it...the thoracodorsal nerve, the thoracodorsal artery...and the corresponding vena communicantes.
Freed from its origins by careful dissection, it has wide anterior and posterior arcs of rotation around this pedicle...
Anterior arc...carrying it as far as the elbow...in repair of elbow flexion deformities! IT COVERS THE MIDDLE THIRD OF THE FACE TO THE UPPER ABDOMEN. But used mainly for post-mastectomy anterior chest wall deformities.
Posterior arc reaching as far as the PARIETAL SKULL (in the head and neck region)!
Dr Tosin Akindele is a medical practitioner and public affairs analyst.