Antegrade Extended Lateral Arm Flap as a Safe and Durable Option for Posterior Elbow Reconstruction: A Descriptive...

Wounds of the posterior elbow present a reconstructive challenge due to the need for durability to withstand the bony prominences while allowing for a large arc of tension-free motion. A variety of options have been described along the entire spectrum of reconstructive surgery. We explore a more straightforward antegrade extended lateral arm flap for its effectiveness in covering these difficult to treat wounds.

Over the course of August 1, 2020, to May 1, 2024, we selected 3 different patients, with posterior elbow wounds that required flap coverage, to investigate an innovative technique for elbow defects. We present these patients in a case series to demonstrate our technique of antegrade extended lateral arm rotation flaps for posterior elbow and olecranon coverage.

This reliable flap has a lower degree of technical difficulty and closes wounds in a tension-free manner. It does not require identification or dissection of perforating vessels. Redundant tissue is intentionally inset over the olecranon to allow for motion free of tension on the skin, and the donor site is covered with a split thickness skin graft. All 3 of our patients' wounds healed, with only 1 complication of prolonged serous drainage from a small wound that resolved with local wound care.

This flap technique for covering posterior elbow wounds is safe, fast, and technically less challenging; has low donor-site morbidity; and provides durable coverage that allows for expedited elbow range of motion.