title: Defect reconstruction over the olecranon with the distally extended lateral arm flap.
abstract: Defect reconstruction over the olecranon should be reliable, quick, relatively simple and with minimal complications. More recently, perforator flaps have been described with the benefit of minimal donor site morbidity when compared with muscle flaps or flaps relying on the major arteries of the upper extremity. So far, most of these flaps were harvested on the upper arm and rotated 180° into the defect. The aim of the present study was to analyse the results with the proximally based, distally extended lateral arm flap for soft-tissue reconstruction over the olecranon. The subcutaneous tissue layer in this area is thinner than in the upper arm, and less rotation of the pedicle is necessary. The location of the perforator just proximal to the lateral epicondyle and the precise territory of the flap are well known. Nine consecutive male patients with a mean age of 57±27 years presenting with soft-tissue defects after surgical treatment of bursitis (eight cases) or a pressure sore (one case) were operated on. The mean operation time was 60±15 min. In eight of the nine cases, the flap healed uneventfully or with a minor complication (fistula). One patient underwent revision surgery due to marginal flap necrosis. The defect was closed with a local advancement flap. In conclusion, the flap was reliable, relatively simple and quick to harvest, and yielded acceptable aesthetic results with minimal bulging over the olecranon. Postoperative recovery was relatively painless and short.
authors.affiliation: Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland; Plastic, Reconstructive, Aesthetic and Hand Surgery, Solothurn Hospitals, Solothurn-Olten-Dornach, Switzerland. Electronic address: drwette@yahoo.com.
authors.forename: R
authors.initials: R
authors.lastname: Wettstein
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Helmy
authors.affiliation: Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland.
authors.forename: D F
authors.initials: DF
authors.lastname: Kalbermatten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000601:surgery; D004550:Elbow / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D056740:Olecranon Process; D011183:Postoperative Complications; D003668:Pressure Ulcer / Q000601:surgery; D012086:Reoperation; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology
keywords: Elbow reconstruction; Perforator flap; Posterior radial collateral artery; Propeller flap