CC BY-NC-ND 4.0 · Indian J Plast Surg 2016; 49(03): 357-361
DOI: 10.4103/0970-0358.197235
Original Article
Association of Plastic Surgeons of India

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

Maksud M. Devale
Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
,
Rohit P. Munot
Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
,
Chirag A. Bhansali
Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
,
Neeraj D. Bhaban
Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
› Author Affiliations
Further Information

Address for correspondence:

Dr. Rohit P. Munot
Department of Plastic Surgery
Room No 450, 4th Floor College Building, Lokmanya Tilak Municipal Medical College, Sion, Mumbai - 400 022, Maharashtra
India.   

Publication History

Publication Date:
26 August 2019 (online)

 

ABSTRACT

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.


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Conflicts of interest

There are no conflicts of interest.

  • REFERENCES

  • 1 Lai CS, Tsai CC, Liao KB, Lin SD. The reverse lateral arm adipofascial flap for elbow coverage. Ann Plast Surg 1997; 39: 196-200
  • 2 Cormack GC, Lamberty BG. Fasciocutaneous vessels in the upper arm: Application to the design of new fasciocutaneous flaps. Plast Reconstr Surg 1984; 74: 244-50
  • 3 Coessens B, Vico P, De Mey A. Clinical experience with the reverse lateral arm flap in soft-tissue coverage of the elbow. Plast Reconstr Surg 1993; 92: 1133-6
  • 4 Fisher J. External oblique fasciocutaneous flap for elbow coverage. Plast Reconstr Surg 1985; 75: 51-61
  • 5 Ikuta Y, Watari S, Kawamura K, Shima R, Matsuishi Y. Free flap transfers by end-to-side arterial anastomosis. Br J Plast Surg 1975; 28: 1-7
  • 6 Kleinman WB, O’Connell SJ. Effects of the fasciocutaneous radial forearm flap on vascularity of the hand. J Hand Surg Am 1993; 18: 953-8
  • 7 Balakrishnan G, Kumar BS, Hussain SA. Reverse-flow posterior interosseous artery flap revisited. Plast Reconstr Surg 2003; 111: 2364-9
  • 8 Gilbert A, Restrepo J. The brachioradial muscle: Anatomy and use as a muscular rotation flap. Ann Chir Plast 1980; 25: 72-5
  • 9 Maruyama Y, Takeuchi S. The radial recurrent fasciocutaneous flap: Reverse upper arm flap. Br J Plast Surg 1986; 39: 458-61
  • 10 Hayashi A, Maruyama Y. Anatomical study of the recurrent flaps of the upper arm. Br J Plast Surg 1990; 43: 300-6
  • 11 Tung TC, Wang KC, Fang CM, Lee CM. Reverse pedicled lateral arm flap for reconstruction of posterior soft-tissue defects of the elbow. Ann Plast Surg 1997; 38: 635-41
  • 12 Morrison CS, Sullivan SR, Bhatt RA, Chang JT, Taylor HO. The pedicled reverse-flow lateral arm flap for coverage of complex traumatic elbow injuries. Ann Plast Surg 2013; 71: 37-9
  • 13 Culbertson JH, Mutimer K. The reverse lateral upper arm flap for elbow coverage. Ann Plast Surg 1987; 18: 62-8

Address for correspondence:

Dr. Rohit P. Munot
Department of Plastic Surgery
Room No 450, 4th Floor College Building, Lokmanya Tilak Municipal Medical College, Sion, Mumbai - 400 022, Maharashtra
India.   

  • REFERENCES

  • 1 Lai CS, Tsai CC, Liao KB, Lin SD. The reverse lateral arm adipofascial flap for elbow coverage. Ann Plast Surg 1997; 39: 196-200
  • 2 Cormack GC, Lamberty BG. Fasciocutaneous vessels in the upper arm: Application to the design of new fasciocutaneous flaps. Plast Reconstr Surg 1984; 74: 244-50
  • 3 Coessens B, Vico P, De Mey A. Clinical experience with the reverse lateral arm flap in soft-tissue coverage of the elbow. Plast Reconstr Surg 1993; 92: 1133-6
  • 4 Fisher J. External oblique fasciocutaneous flap for elbow coverage. Plast Reconstr Surg 1985; 75: 51-61
  • 5 Ikuta Y, Watari S, Kawamura K, Shima R, Matsuishi Y. Free flap transfers by end-to-side arterial anastomosis. Br J Plast Surg 1975; 28: 1-7
  • 6 Kleinman WB, O’Connell SJ. Effects of the fasciocutaneous radial forearm flap on vascularity of the hand. J Hand Surg Am 1993; 18: 953-8
  • 7 Balakrishnan G, Kumar BS, Hussain SA. Reverse-flow posterior interosseous artery flap revisited. Plast Reconstr Surg 2003; 111: 2364-9
  • 8 Gilbert A, Restrepo J. The brachioradial muscle: Anatomy and use as a muscular rotation flap. Ann Chir Plast 1980; 25: 72-5
  • 9 Maruyama Y, Takeuchi S. The radial recurrent fasciocutaneous flap: Reverse upper arm flap. Br J Plast Surg 1986; 39: 458-61
  • 10 Hayashi A, Maruyama Y. Anatomical study of the recurrent flaps of the upper arm. Br J Plast Surg 1990; 43: 300-6
  • 11 Tung TC, Wang KC, Fang CM, Lee CM. Reverse pedicled lateral arm flap for reconstruction of posterior soft-tissue defects of the elbow. Ann Plast Surg 1997; 38: 635-41
  • 12 Morrison CS, Sullivan SR, Bhatt RA, Chang JT, Taylor HO. The pedicled reverse-flow lateral arm flap for coverage of complex traumatic elbow injuries. Ann Plast Surg 2013; 71: 37-9
  • 13 Culbertson JH, Mutimer K. The reverse lateral upper arm flap for elbow coverage. Ann Plast Surg 1987; 18: 62-8