Department of Hand and Upper Extremity Surgery, Edouard Herriot Hospital, 5 Place d'Arsonval, 69003, Lyon, France.
Department of Hand and Upper Extremity Surgery, Saint-Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.
Eur J Trauma Emerg Surg. 2024 Aug;50(4):1733-1740. doi: 10.1007/s00068-024-02527-6. Epub 2024 Apr 13.
Soft tissue coverage of the posterior aspect of the elbow requires thin and flexible flaps to adapt to movements without constraining them. The authors report a clinical series of reconstruction by the descending superficial radial artery (DSRA) flap, a proximal forearm perforator flap which use is rarely reported in the literature.
Seven patients with a mean age of 50 years (range 24-88 years) were treated for a posterior elbow defect using the DSRA flap with an adipofascial pedicle. The flap was tunneled to the defect in the subcutaneous tissue or raised using the racket-like technique to avoid any pedicle compression.
The mean follow-up was 3.3 months (range 1-12 months). A partial necrosis of the skin paddle occurred in an 88-year-old patient. In the other cases, the flap evolution was straightforward. At the last follow-up, the appearance of the flaps was satisfactory in terms of color, texture, and thickness. No complications were observed at the donor site.
The DSRA flap with an adipofascial pedicle is a simple, reliable, and reproducible method for reconstruction of small to moderate-sized defect on the posterior aspect of the elbow. Its use is easier for defects on the posterolateral side, but it can reach the medial olecranon.
肘部后区的软组织覆盖需要薄而灵活的皮瓣,以适应运动而不限制它们。作者报告了一组使用桡动脉浅降支(DSRA)皮瓣进行重建的临床病例,该皮瓣是一种近端前臂穿支皮瓣,在文献中很少有报道。
7 名平均年龄 50 岁(24-88 岁)的患者因肘部后区缺陷接受了带脂肪筋膜蒂的 DSRA 皮瓣修复。皮瓣通过皮下组织隧道或使用球拍样技术抬高,以避免任何蒂部受压。
平均随访 3.3 个月(1-12 个月)。1 名 88 岁的患者出现皮瓣部分坏死。在其他病例中,皮瓣的演变是直接的。末次随访时,皮瓣的外观在颜色、质地和厚度方面均令人满意。供区无并发症。
带脂肪筋膜蒂的桡动脉浅降支皮瓣是一种简单、可靠、可重复的方法,可用于重建肘部后区小至中等大小的缺陷。对于后外侧的缺陷,其使用更为容易,但也可以到达内上髁。