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[The reconstruction of soft tissue defects in the elbow area: a treatment algorithm proposal]
Ahmet Duymaz1, Furkan Erol Karabekmez, Mustafa Keskin
1Selcuk University, Meram Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Meram, Konya, Turkey.
Background:
The reconstruction of soft tissue defects of the elbow area (including antecubital fossa and peri-olecranon area) should be performed with the most appropriate soft tissue and functional rehabilitation immediately.
Methods:
Ten patients were included in this study. One had a brachial artery defect, another had postburn axillary contracture deformity, and a third had an ulnar bone body fracture in addition to their soft tissue defects, while the remaining seven had only soft tissue defect. Patients underwent surgical closure either by local arm fasciocutaneous flap (1), radial forearm flap (1), multiple Z-plasty (1), pedicled latissimus dorsi muscle flap (3), or with the antecubital fasciocutaneous island flap (4).
Results:
The follow-up was 9 months to 4 years (mean: 19 months). All the flaps achieved wound closure without losing the range of motion at the elbow joint.
Conclusion:
Surgical closure of the antecubital fossa and peri-olecranon areas can be a challenge for plastic surgeons since this area includes numerous neuro-vascular bundles and a functional joint. Therefore, we describe herein an algorithm for the treatment of defects in these areas from the inspiration in our clinical experience and a literature review. Our algorithm will help to decide the most appropriate choice among all of the surgical options available.
