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Medial Distal Arm Perforator Flap for elbow Soft Tissue Defects: A Cadaveric Study
Pierre-Antoine Guillaume1, Coralie Bordas2, Martin Cholley-Roulleau3
1Institut de Chirurgie Orthopédique Flandres Audomarois, Clinique ELSAN de Saint Omer, 71 Rue Ambroise Paré 62575 Blendecques, France; Department of Anatomy, Faculty of Medicine, University of Lorraine, 9 Av. de la Forêt de Haye, 54500 Vandœuvre-lès-Nancy, France; Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre François Xavier Michelet, CHU de Bordeaux, Place Amélie Raba Léon, 33000 Bordeaux, France.
The medial distal arm perforator flap is a reliable option for covering elbow soft-tissue defects. This anatomical study confirms its technical feasibility and reproducibility, offering an effective alternative to traditional flaps.
Area of Science:
- Plastic Surgery
- Anatomy
- Reconstructive Surgery
Background:
- Elbow soft-tissue defects present reconstructive challenges.
- Conventional flaps may involve sacrifice of major arteries.
- A reliable and reproducible flap is needed for elbow coverage.
Purpose of the Study:
- To assess the technical feasibility and reproducibility of a medial distal arm perforator flap.
- To evaluate its suitability for covering various elbow soft-tissue defects.
- To propose a standardized flap design.
Main Methods:
- Cadaveric anatomical study on seven fresh adult upper limbs.
- Defined a theoretical flap pivot point and skin-paddle width.
- Assessed perforator origin, number, distance, and diameter; simulated defect coverage.
Main Results:
- 2-5 perforators identified per limb, originating from brachial or superior ulnar collateral arteries.
- Median perforator distance: 8.0 cm; median diameter: 0.65 mm.
- Successful coverage of medial epicondyle, distal biceps, and olecranon defects; 6/7 limbs covered lateral epicondyle defects.
Conclusions:
- The medial distal arm perforator flap is a reliable and reproducible option for elbow defects.
- It offers an effective alternative to conventional flaps without sacrificing major arteries.
- A standardized flap design with a defined pivot point and boundaries is proposed.
