Background:Soft tissue defects on the posterior aspect of the elbow are commonly seen in patients treated with internal fixation for fractures around the elbow joint. An axial flap based on the radial recurrent artery (RRA) is very useful for such defects, especially if a posterior midline arm incision has been taken for skeletal fixation. The aim of this study is to describe the usefulness of RRA flap (based on the RRA) in the management of such defects.Materials and Methods:We present a retrospective analysis of 4 cases managed with the RRA flap for soft tissue reconstruction of defects around the elbow joint at our institute from January 2015 to August 2016. All the patients were males with a history of exposed implant following internal fixation of olecranon/distal humerus fracture. The size of defects ranged from 4 cm × 4 cm to 7 cm × 5 cm. Results of the analysis are presented here.Results:All flaps survived completely. There was no infection, hematoma or distal neurovascular deficit. There was minimal donor site morbidity.Conclusion:The RRA flap is a useful, simple flap for defects around the elbow joint in select patients providing one stage, reliable, cosmetically acceptable coverage.
Electrical current can cause neurological damage directly or by conversion to thermal energy. However, electrical injury causing isolated brachial plexus injury without cutaneous burns is extremely rare. We present a case of a 17-year-old boy who sustained accidental electrical injury to left upper extremity with no associated entry or exit wounds. Complete motor and sensory loss in upper limb were noted immediately after injury. Subsequently, the patient showed partial recovery in muscles around the shoulder and in ulnar nerve distribution at 6 months. However, there was no improvement in muscles supplied by musculocutaneous, median and radial nerves. On exploration at 6 months after trauma, injury to the infraclavicular plexus was identified. Reconstruction of musculocutaneous, median and radial nerves by means of sural nerve cable grafts was performed. The patient has shown excellent recovery in musculocutaneous nerve function with acceptable recovery of radial nerve function at 1-year post-injury.
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