The lateral arm flap for reconstruction of tissue defects due to olecranon bursitis

Abstract

Wound healing problems following acute and chronic olecranon bursitis can result in problematic tissue defects around the elbow. These defects often require a regional flap or a free flap for durable tissue coverage. The aim of this study was to assess clinical outcome the lateral arm flap (LAF) used to cover tissue defects caused by chronic olecranon bursitis. Between 2011 and 2015, 13 patients with soft tissue defects of the elbow resulting from chronic bursitis olecrani were treated in an interdisciplinary approach. First sufficient debridement was performed in conjunction with the orthopedic surgeons. Then, using a defect specific algorithm, reconstruction followed using pedicled extended LAFs or reverse LAFs, with and without inclusion of triceps muscle tissue. Mean follow-up was 52.3 months (range 23-72 months). There were no complete flap losses. All flaps healed in nicely without major wound healing complications. No patient showed signs of recurrent infections during follow-up, and all patients were able to achieve full range of motion post-operatively. Depending on the size of the defect, the conditions of the surrounding tissues, involvement of the elbow joint or need for sensate tissue, reconstruction may require different approaches. In our opinion the LAF can be designed to address these demands.

Free flap reconstruction of elbow soft tissue defects: Lessons learned from 15 years of experience

“…Previous studies have demonstrated the benefits of various local flaps and regional pedicled flaps for elbow reconstruction (di Summa et al, 2020; Elhassan et al, 2011; Heidekrueger et al, 2018; Nakao et al, 2018; Tung et al, 1997; Türegün et al, 2005; Zampeli et al, 2019). However, high rates of reoperation and unsuccessful definitive coverage following total elbow arthroplasty have been reported, resulting in subsequent free flap reconstruction (Adkinson & Chung, 2014; Patel & Higgins, 2013).…”