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Elbow defect coverage with a one-staged, tunneled latissimus dorsi transposition flap
L D Chang1, N H Goldberg, B Chang
1Division of Plastic and Reconstructive Surgery, University of Maryland, Baltimore.
Annals of Plastic Surgery
|May 1, 1994
Summary
The latissimus dorsi transposition flap is a safe and effective one-stage procedure for covering complex elbow defects. This technique offers reliable soft-tissue coverage, making it the preferred choice for elbow reconstruction.
Area of Science:
- Orthopedic Surgery
- Plastic Surgery
- Microsurgery
Background:
- Reconstruction of the upper extremity presents challenges due to limited local muscle availability.
- The latissimus dorsi muscle has been utilized for various upper limb reconstructions, including elbow and forearm restoration, and soft-tissue defects of the upper arm and shoulder.
Observation:
- Literature review indicated no prior reports of latissimus dorsi muscle use for pure coverage of complex elbow wounds.
- The authors successfully employed the latissimus dorsi transposition flap for single-stage coverage of complex elbow defects in four patients.
Findings:
- The latissimus dorsi transposition flap was the primary choice in three patients and a successful alternative in one patient with a failed rectus abdominis free tissue transfer for an open comminuted elbow fracture.
- The described technique involves transferring the latissimus dorsi muscle on its vascular pedicle, with or without a skin island, for defect coverage.
Implications:
- This one-stage procedure is safe, demonstrates minimal donor site morbidity, and provides reliable coverage for complex elbow defects.
- The latissimus dorsi transposition flap should be considered the flap of choice for elbow coverage in reconstructive surgery.