Does pectoralis major flap harvesting induce upper extremity dysfunction?

Objective: To evaluate the effect of pectoralis major myocutaneous (PMM) flap reconstruction on upper extremity dysfunction.

Methods: Patients undergoing PMM flap reconstruction following head and neck cancer resection were enrolled. The control group comprised age-, sex- and clinical characteristic-matched patients undergoing non-PMM flap reconstruction. All patients completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire preoperatively and >1 year postoperatively.

Results: There was no significant difference between pre- and postoperative DASH scores in the control group (n = 46; 2.38 ± 3.33 and 2.99 ± 4.21, respectively). In the PMM flap group (n = 46), the postoperative DASH score was significantly higher than the preoperative score (7.00 ± 9.13 and 2.44 ± 3.50, respectively). In the PMM flap group, flap size was significantly associated with postoperative DASH score.

Conclusion: PMM flap reconstruction has a small but significant negative effect on upper extremity dysfunction.