The authors present a long-term outcome study of patients with elbow defects requiring flap coverage in order to compare the different coverage options. In this retrospective review spanning from 1988-2005, a total of 99 flaps were performed for 96 patients with an average follow up of 32 months. Reasons for the elbow soft tissue defect included: trauma, tumors, infection, olecranon bursitis, burn contractures, and pressure sores. Flap coverage included: random local fasciocutaneous flaps (15%), local and distant pedicled flaps (66%), and free tissue transfer (19%).
In this series, 10 % of patients had reconstructive failures requiring a second flap. The overall complication rate was 31% with the pedicled latissimus dorsi flap having a significantly higher complication rate (57%) than other flaps. The authors feel that the distal tip of the pedicled latissimus dorsi flap is unreliable when used to cover defects distal to the olecranon and recommend coverage of the proximal ulna with the radial forearm flap or a free flap.
Elbow, Coverage, Soft, Tissue, Flap