Reverse-Flow Versus Perforator Propeller Lateral Arm Flap for Elbow Reconstruction.

Area of Science:

• Microsurgery
• Orthopedic Surgery
• Plastic Surgery

Background:

• The lateral arm flap (LAF) is a viable option for elbow reconstruction, known for minimal donor site morbidity and consistent anatomy.
• Two techniques exist: reverse-flow LAF and radial collateral artery perforator (RCAP) flap.
• This study compares the immediate and long-term outcomes of these two LAF techniques for elbow reconstruction.

Purpose of the Study:

• To compare the functional and aesthetic outcomes of reverse-flow LAF versus RCAP flap for elbow reconstruction.
• To evaluate operative time, healing, and complication rates between the two flap techniques.

Main Methods:

• A retrospective review of 15 patients (9 males, 6 females) who underwent elbow reconstruction using either reverse-flow LAF or RCAP flap.
• Data collected included defect etiology, comorbidities, operative time, healing time, and hospital stay.
• Functional outcomes were assessed using the Quick Disability of Arm Shoulder and Hand (Quick DASH) score.

Main Results:

• Seven reverse-flow LAF and eight RCAP flaps were performed. No major functional limitations or aesthetic dissatisfaction were reported.
• RCAP flap harvest was significantly faster, with shorter hospitalization (P < 0.05).
• Complications included partial RCAP flap necrosis (1 patient) and distal venous congestion in 4 reverse-flow flaps, requiring further intervention in one case.

Conclusions:

• The RCAP flap technique for elbow reconstruction requires less operative time and hospital stay compared to the reverse-flow LAF.
• RCAP flaps are less prone to venous congestion and are recommended over reverse-flow LAF when suitable perforators are present.
• Both techniques offer satisfactory functional and aesthetic outcomes for elbow reconstruction.