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Updated: Jan 15, 2026

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
Posterior ulnar recurrent artery perforator flap for elbow reconstruction: a forearm-based propeller flap
Jenaleen Law1,2, Isobel Yeap1, Bishoy Soliman1,3
1Department of Plastic and Reconstructive Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia.
None:
Soft tissue reconstruction around the elbow is challenging due to the need for durable yet pliable coverage that preserves joint mobility and function. We present the case of a 56-year-old gentleman with a chronic elbow wound secondary to osteomyelitis. Following debridement, the defect was reconstructed using a posterior ulnar recurrent artery perforator (PURAP) flap designed in a propeller style. Unlike previous reports that have described PURAP flaps based on arm perforators, this case uniquely utilised perforators arising from the forearm. This forearm-based approach offers several advantages, including reduced donor-site morbidity, and avoidance of dissection near the ulnar nerve. This case highlights the versatility and safety of the forearm-based PURAP flap for elbow reconstruction. Level of evidence: Level 5.
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