A buried interpolated local fasciocutaneous flap for tension-free closure of the chronic olecranon wound.

Chronic olecranon wounds, in spite of their diminutive size, can truly be a big nuisance in any attempt to heal them without resorting to some form of vascularized flap. Although nearby pedicled skin flaps or even free flaps can suffice, local fasciocutaneous flaps based solely on the existing regional fascial plexus are much simpler and just as reliable. An improvement of this concept is the buried interpolated fasciocutaneous flap that brings adjacent, supple forearm tissues into the defect. Unlike a more conventional interpolation flap that is brought over normal tissues, by instead burying a deepithelialized portion of this flap underneath any intervening tissues will allow in a single stage the replacement of missing tissues in a relatively tension-free manner. Over the past year, this maneuver in 4 patients has proven to be a satisfactory outpatient procedure with rapid healing, minimal complications, and ultimately full restoration of elbow motion.