Neurotized Free Anterolateral Thigh Flap for Large Tissue Defect and Joint Exposure in the Setting of Olecranon...

Elbow wounds secondary to septic olecranon bursitis are a challenging problem to treat. Neurotized fasciocutaneous free anterolateral thigh (ALT) flaps provide a reliable soft tissue coverage option with the opportunity to provide protective sensation to a common pressure point. Free flaps can provide coverage when alternative options lower on the reconstructive ladder are unavailable. A 69-year-old man with rheumatoid arthritis presented with septic olecranon bursitis requiring serial debridement resulting in significant soft tissue loss and bone exposure. A free ALT, with fascial tacking sutures, was used for reconstruction with subsequent neurotization resulting in successful resolution of bursitis and persistent fluid drainage. Neurotized free ALT flaps provide durable soft tissue coverage for a challenging area to treat while also providing sensory protection to a pressure point area.