Latissimus dorsi muscle transfer for reconstruction of traumatic deltoid deficiency: a report of two cases.

Introduction and importance: Traumatic deltoid muscle deficiency results in significant impairment of shoulder function despite preserved distal upper-limb mobility. The pedicled latissimus dorsi muscle transfer (LDT) is a promising reconstructive option; however, its application in traumatic deltoid loss remains underreported, particularly in resource-limited and conflict-affected settings. Case presentation: We report two cases of traumatic deltoid deficiency managed with pedicled LDT. Case 1 involved a 23-year-old male with deltoid and supraspinatus avulsion following a projectile injury. Reconstruction with pedicled LDT resulted in restoration of active shoulder abduction up to 100° at 5-year follow-up. Case 2 involved a 14-year-old male with extensive musculocutaneous loss following a crush injury. Reconstruction with pedicled LDT and split-thickness skin grafting resulted in substantial functional recovery at 1-year follow-up. Clinical discussion: Both cases demonstrated meaningful functional improvement following pedicled LDT. Preservation of the thoracodorsal neurovascular bundle was critical for successful reconstruction. Functional recovery was facilitated through postoperative rehabilitation and neuromuscular adaptation. This technique remains particularly valuable in settings where microsurgical reconstruction is limited. Conclusion: Pedicled LDT offers a reliable reconstructive solution for traumatic deltoid deficiency, restoring functional mobility and improving shoulder contour, especially in young patients with preserved neurovascular integrity.