Defect reconstruction over the olecranon with the distally extended lateral arm flap

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Olecranon defect reconstruction requires reliable, simple, and quick methods with minimal complications.
• Perforator flaps offer reduced donor site morbidity compared to traditional muscle or major artery flaps.
• Existing perforator flaps for olecranon defects often involve harvesting from the upper arm with significant rotation.

Purpose of the Study:

• To analyze the outcomes of using a proximally based, distally extended lateral arm flap for soft-tissue reconstruction over the olecranon.
• To evaluate the flap's reliability, simplicity, speed of harvest, and complication rate.
• To assess the aesthetic results and patient recovery associated with this flap technique.

Main Methods:

• A prospective study involving nine male patients with olecranon soft-tissue defects.
• Defects were secondary to surgical treatment for bursitis (eight cases) or pressure sores (one case).
• The proximally based, distally extended lateral arm flap was utilized for reconstruction.

Main Results:

• The mean operation time was 60±15 minutes.
• Eight of nine flaps healed uneventfully or with minor complications (fistula).
• One patient required revision surgery for marginal flap necrosis; defect closure was achieved with a local advancement flap.

Conclusions:

• The proximally based, distally extended lateral arm flap is a reliable, simple, and quick option for olecranon reconstruction.
• The flap provides acceptable aesthetic outcomes with minimal olecranon bulging.
• Patients experienced relatively painless and short postoperative recovery.