Purpose of the study: The latissimus dorsi free flap is widely used for reconstruction of large tissue defects. It is always difficult however to explain the procedure to the patient, particularly the potential sequelae. The purpose of this work was to assess sequelae affecting shoulder function and the esthetic aspect of the harvesting site.

Material and methods: We reviewed 16 patients (17 harvestings) aged 37.8 years on average (range 22–62 years), twelve men and four women, at mean follow-up of 4.5 years. All flaps had been harvested to reconstruct tissue defects of the lower limb. Eleven were semi-emergency procedures, four for chronic defects or reconstruction after tumor resection. We assessed the esthetic aspect of the harvesting zone and shoulder function suing Cybex 6000 (comparative isokinetic tests of the two shoulders). The Dash score was noted.

Results: Functional impairment was minimum in all patients. The Dash score was 17.5%. (compared with the opposite side was: 27% abduction, 22% extension and 10% rotation. Adduction, flexion and external rotation were preserved. The esthetic aspect was acceptable but not negligible. Obesity appeared to accentuate disgraceful scars.

Discussion and conclusion: The latissimus dorsi free flap is often indicated for reconstruction of significant tissue defect. Shoulder function is largely preserved. Patients should be informed about the major scar. The side to be harvested should be discussed with the patient, even in the emergency situation.