Innervated superficial circumflex iliac artery perforator flap for refractory elbow ulcer with bone exposure in...

Werner syndrome is a rare autosomal recessive progeroid disorder first described by Werner and is characterized by premature aging, progressive cutaneous and subcutaneous atrophy, impaired wound healing, and premature arteriosclerosis, which contribute to chronic refractory ulceration and may lead to bone exposure and functional impairment. We report a case of a 52-year-old man with Werner syndrome who developed a refractory ulcer over the right olecranon with bone exposure. Reconstruction was performed using an innervated superficial circumflex iliac artery perforator (SCIP) flap, with vascular anastomosis to the inferior ulnar collateral artery and sensory neurorrhaphy to the medial antebrachial cutaneous nerve. The postoperative course was uneventful. The flap survived completely, protective sensation was preserved, and elbow function improved. No ulcer recurrence or other complications were observed during the 5-year follow-up period. This case suggests that an innervated SCIP flap can provide durable, sensate, and function-preserving reconstruction for refractory elbow ulcer with bone exposure in Werner syndrome.