[Musculocutaneous flaps for increased load capacity of the above-elbow stump]

Above-elbow amputations for severe injury or fourth degree burns may leave an unsatisfactory stump. Fitting of a prosthesis is always difficult. Similar difficulties may arise with congenital transverse absence, while all childhood amputations have the potential problem of bony overgrowth threatening to penetrate skin. Because the stump is already too short, re-amputation is not an acceptable solution. We recommend improvement of such stumps by the transfer of a latissimus dorsi musculocutaneous flap. The principles and details are discussed.