Efficacy of Reverse - Flow Lateral Arm Flap for Coverage of Defects Around the Elbow in Pediatric Patients | ||||
The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
Article 9, Volume 46, Issue 1, January 2022, Page 51-57 PDF (19.78 MB) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejprs.2022.220430 | ||||
View on SCiNiTO | ||||
Authors | ||||
Sherif M. El Kashty* ; Mohamed Abo Shaban; Ahmed A. Taalab | ||||
The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Menoufia University | ||||
Abstract | ||||
Background: Coverage of defects around the elbow can be treated by a variety of procedures as skin grafts, regional flaps, muscle flaps and free flaps. The reverse flow lateral arm flap (LAF) is a valuable option in coverage of these defects. The vascular basis of this flap, via the multiple communications around the elbow between the collateral and recurrent arteries, is consistent and reliable. Aim of the Study: To explore the utility of the reverse flow lateral arm flap (LAF) in management of defects around the cubital fossa region in pediatric patients. Patients and Methods: This work was executed at The Menoufia University Hospitals, from October 2017 to December 2018, following our cases post-operatively for an average one year. It entailed eight patients, six boys and two girls. The age of our cases was from 4 to 11 years. Six patients had post-burn contracture release defects, and 2 patients had traumatic avulsion of antecubital skin. All the defects were covered by the reverse-flow lateral arm flap (LAF) with skin grafting of the donor site. Results: All the flaps survived completely, except one case showed distal superficial necrosis and healed spontaneously. We applied skin graft to the flap donor site in the eight patients. Flap size ranged from 15x7 cm. to 12x5cm. Aesthetically, the flap and donor sites were satisfactory, and functionally, the range of motion of elbow was very adequate. One patient developed transient radial nerve palsy and completely recovered by conservative treatment and physiotherapy. Conclusion: The reverse flow lateral arm flap (LAF) is a valuable single-stage option in coverage of defects around the elbow. It provides reliable and stable coverage of these defects without sacrificing major vessel or functional muscle unit. The flap had satisfactory aesthetic and functional outcome. | ||||
Keywords | ||||
Lateral arm flap; Elbow defects; Antecubital contractures | ||||
Supplementary Files
|
||||
References | ||||
1- Joshua M.A. and Kevin C.C.: Flap Reconstruction of the Elbow and Forearm: A Case-Based Approach. Hand Clin., 30 (2): 153-163, 2014. 2- Stevanovic M. and Sharpe F.: Soft-tissue coverage of the elbow. Plast. Reconstr. Surg., 132 (3): 387e-402e, 2013. 3- Davami B. and Perkhamene G.: Versatility of local fasciocutaneous flaps for coverage of soft tissue defects in upper extremity. J. Hand Microsurg., 3 (2): 58-62, 2011. 4- Patel K.M. and Higgins J.P.: Posterior elbow wounds: Soft tissue coverage options and techniques. Orthop. Clin. N. Am., 44: 409-417, 2013. 5- Ravikiran N., Shashank C., Aniket D., et al.: Reconstruction of post-traumatic upper extremity soft tissue defects with pedicled flaps: An algorithmic approach to clinical decision making. Chin J. Traumatol., 21 (6): 338-351, 2018. 6- Megerle K., Sauerbier M. and Germann G.: The evolution of the pedicled radial forearm flap. Hand (NY), 5: 37-42, 2010. 7- Zenn M.R. and Jones Glyn: Radial Forearm Flap. In: Reconstructive Surgery: Anatomy, Technique, and Clinical Applications. QMP, Inc; St Louis, Missouri, p. 885, 2012. 8- Rockwell W.B. and Ley E.: Abdominal Flaps. In: Rayan G.M., Chung K.C., editors. Flap Reconstruction of the Upper Extremity: A Master Skills Publication. American Society for Surgery of the Hand; Rosemont IL, p. 171- 177, 2009. 9- King E.A. and Ozer K.: Free skin flap coverage of the upper extremity. Hand Clin., 30: 201-209, 2014. 10- Sauerbier M. and Geissler G.: Lateral Arm Flap for Hand Wrist Coverage. In: Moran S.L., Cooney W.P., editors. Soft Tissue Surgery: Master Techniques in Orthopedic Surgery. Lippincott Williams and Wilkins; Philadelphia, PA, pp. 179-180, 2009. 11- Song R., Song Y. and Yu Y.: The upper arm free flap. Clin. Plast. Surg., 9: 27-359, 1982. 12- Katsaros J., Shusterman M., Beppu M., et al.: The lateral upper arm flap: Anatomy and clinical applications. Ann. Plast. Surg., 12: 489-500, 1984. 13- Graham B., Adkins P. and Scheker L.: Complications and morbidity of the donor and recipient sites in 123 lateral arm flaps. J. Hand Surg. Br., 17: 189-192, 1992. 14- Depner C., Erba P., Rieger U.M., et al.: Donor-site morbidity of the sensate extended lateral arm flap. J. Reconstr. Microsurg., 28: 133-138, 2012. 15- Tung T.C., Wang K.C., Fang C.M. and Lee C.M.: Reverse pedicled lateral arm flap for reconstruction of posterior soft-tissue defects of the elbow. Ann. Plast. Surg., 38: 635-641, 1997. 16- Turegun M., Nisanci M., Duman H., et al.: Versatilityof the reverse lateral arm flap in the treatment of post-burn antecubital contractures. Burns, 31: 212-216, 2005. 17- Prantl L., Schreml S., Schwarze S., et al.: A safe and simple technique using the distal pedicled reversed upper arm flap to cover large elbow defects. J. Plast. Reconstr. Aesthet. Surg., 61 (5): 546-551, 2008. 18- Morrison C.S., Sullivan S.R., Bhatt R.A., et al.: The pedicled reverse-flow lateral arm flap for coverage of complex traumatic elbow injuries. Ann. Plast. Surg., 71: 37-39, 2013. 19- Sami Ullah, Muhammad Asif, Muhammad Ubaid, et al.: Lateral Arm Flap: Its Usage as Pedicled and Free Flap. Cureus, 12 (2): e12136, 2020 | ||||
Statistics Article View: 177 PDF Download: 569 |
||||