Awkward defects around the elbow: The radial recurrent artery flap revisited

Devale, Maksud; Munot, Rohit P; Bhansali, Chirag A; Bhaban, Neeraj D

doi:10.4103/0970-0358.197235

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…In cases of olecranon fracture with skin defects, flaps based on the middle collateral artery cannot be used because of damage to the perforators on the posterior side of the elbow 14) . The radial and ulnar artery forearm flaps are not preferred because they sacrifice the major arteries of the forearm 15) .…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Delayed Arterial Occlusion After Reconstruction of Gustilo IIIB Severe Olecranon Fracture

Fujioka

Fukui

Yoshino

et al. 2023

International Journal of Surgical Wound Care

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Gustilo-Anderson grade IIIB severe open fracture of the olecranon with skin defect require early wound covering to treat the fracture, but wound covering with simple topical flaps or skin grafts is often difficult due to surrounding skin damage and bone exposure. Consequently, it requires some kind of flap reconstruction. We presented 2 cases of treatment for exposed olecranon degloving trauma (Gustilo-Anderson grade IIIB), and discussed the selection of flaps for these complex injuries, based on the points of reflection on the complications. When injured by this type of high-energy trauma, the surgeon should be aware of the following two points. Firstly, the arterial perforator branch to the skin around the wound is torn by shear stress, and secondly, delayed arterial embolism can occur. Therefore, a flap should be obtained outside the zone of injury. Therefore, for forearm injuries, the flap should be raised from the upper arm, and for upper arm injuries, the flap should be raised from the forearm. A free flap is the choice for extensive injuries from the upper arm to the forearm.

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Section: Discussionmentioning

confidence: 99%

Two Cases of Delayed Arterial Occlusion After Reconstruction of Gustilo IIIB Severe Olecranon Fracture

Fujioka

Fukui

Yoshino

et al. 2023

International Journal of Surgical Wound Care

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“…The anatomical textbooks describe the termination of DBA as a bifurcation into middle and radial collateral arteries, which take part in the peri-articular arterial anastomoses around the elbow (Moore et al, 2017). However, many sources do not mention the posterior radial collateral artery or the anterior radial collateral artery as the terminal branches (Devale et al, 2016) or as alternative names for the branches of the DBA. However, Meirer et al performed an anatomic study carried out on 28 cadaveric arms, to investigate the principal artery of the lateral forearm flap (Meirer et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

The deep brachial artery—A meta‐analysis of its origin and diameter with a review of the literature

et al. 2022

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The deep brachial artery (DBA) is the first and largest branch of the brachial artery. Multiple variations of the DBA's origin, termination, and diameter have been reported in the literature. Major online medical databases such as PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched in order to find all studies considering origin variations and the diameter of the DBA. The prevalence of the DBA originating directly from the axillary or brachial artery was shown to be 92.87%. DBA originating indirectly from the axillary or brachial artery, as a common trunk with other arteries, was found to be 7.13%. The mean diameter of the DBA was shown to be 2.05 mm. The authors of the present study believe that this is the most accurate and up-to-date meta-analysis considering origin patterns and the diameter of the DBA. Additionally, this study contains a comprehensive literature review in which current detailed anatomical knowledge concerning the DBA was gathered. The results of this study could provide a helpful tool for physicians, especially surgeons, dealing with an upper limb in their daily practice.

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“…Their study also included RFF, brachioradialis, pedicled LD, and local perforator flaps as coverage options for posterior elbow that correlates with our case series. The RLA flap can also be based anterior to the lateral epicondyle to include perforators of RRA in the flap base, which minimizes the kink and prevents venous congestion as suggested by Devale et al 6 In a recent review article by Gandolfi et al, 7 the lateral arm flap was the most reported flap in their review due to its obvious advantages.…”

Section: Discussionmentioning

confidence: 99%

Management of Posttraumatic Posterior Elbow Defects by Nonmicrosurgical Reconstruction

Pawar

Sahasrabudhe

Panse

et al. 2022

Indian J Plast Surg

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Introduction Reconstruction of posterior defects is challenging due to the quality and uniqueness of the excess skin at the elbow that is durable, thick, pliable, and without much subcutaneous tissue. The goal of reconstruction is to cover the elbow defects with a durable skin cover that will facilitate full passive range of motion. In this era of microsurgery, free tissue transfer is feasible for almost any defect. However, in this article, we discuss various locoregional and pedicled flap options and the protocol followed at our institute to tackle posttraumatic posterior elbow defects. Materials and Methods This is a retrospective analysis of 48 patients with posttraumatic posterior elbow defects admitted from January 2012 to February 2020. Posterior elbow defects were assessed according to the size and location and managed with a nonmicrosurgical reconstruction. Results Of 48 patients, 32 were managed with nonmicrosurgical flaps. Eighteen patients had large defects and 14 had small defects. Reverse lateral forearm flap was the workhorse flap for defect coverage. Of 32 flaps, nine developed complications; however, no patient had total flap necrosis. Conclusion Posterior elbow defects are a difficult problem to tackle. To achieve optimal results, all patients with elbow trauma should be attended and managed by orthopaedic and plastic surgeons in collaboration for optimal results. We believe that most of these defects can be resurfaced by nonmicrosurgical reconstruction with proper planning and execution and their utility cannot be understated.

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Awkward defects around the elbow: The radial recurrent artery flap revisited

Cited by 6 publications

References 13 publications

Two Cases of Delayed Arterial Occlusion After Reconstruction of Gustilo IIIB Severe Olecranon Fracture

Two Cases of Delayed Arterial Occlusion After Reconstruction of Gustilo IIIB Severe Olecranon Fracture

The deep brachial artery—A meta‐analysis of its origin and diameter with a review of the literature

Management of Posttraumatic Posterior Elbow Defects by Nonmicrosurgical Reconstruction

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