Abstract
Introduction Traditionally, the latissimus dorsi muscle with or without skin paddle has been the
flap of choice for coverage of elbow defects. The ALT flap has found application in
elective upper limb defects on account of it’s ability to be tailor made for individual
defects. Our series of 10 cases shows the advantages of using this flap for acute
trauma defects.
Materials and Methods Consecutive 10 cases of severe elbow injuries, involving varying amounts of the lower
arm and proximal forearm underwent debridement followed by coverage using the free
anterolateral thigh flap. Nine of 10 arterial anastomosis were done end to side to
the brachial artery and venous anastomosis to the veins accompanying the artery. Seven
of these patients had long bone fractures and elbow dislocations, stabilised using
external fixator. Four patients needed primary muscle or tendon repair and nerve repair
or graft.
Results There was 1 total flap loss, intraoperatively where a TFL flap had been used in a
71 year-old patient. Nine of 10 had successful wound coverage. Using Jupiter criteria,
2 had excellent, 3 had good, 3 had fair, and 1 had poor outcome.
Conclusion This consecutive series of moderate and severe elbow injuries demonstrates that the
ALT flap should be considered as the flap of first choice, specifically when there
is a need.
Keywords
anterolateral thigh flap - elbow injuries - acute trauma
