CC BY-NC-ND 4.0 · Indian J Plast Surg 2022; 55(03): 251-261
DOI: 10.1055/s-0042-1750372
Original Article

Management of Posttraumatic Posterior Elbow Defects by Nonmicrosurgical Reconstruction

1   Department of Plastic & Reconstructive Surgery, B.J. Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
,
Parag Sahasrabudhe
1   Department of Plastic & Reconstructive Surgery, B.J. Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
,
Nikhil Panse
1   Department of Plastic & Reconstructive Surgery, B.J. Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
,
1   Department of Plastic & Reconstructive Surgery, B.J. Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
,
Rohit Dagadu Phulwer
1   Department of Plastic & Reconstructive Surgery, B.J. Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
› Author Affiliations

Abstract

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.



Publication History

Article published online:
17 August 2022

© 2022. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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