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Elbow Reconstruction
Clinical Presentation
An 18-year-old White male had multiple subcutaneous rheumatoid nodules over his left elbow. He complained about pain and discomfort in the area and agreed to surgical resection to remove the subcutaneous lesions. Because of the large area affected, a large soft tissue defect was anticipated after surgical resection for these lesions ( Fig. 17.1 ).
Operative Plan and Special Considerations
Based on the size and location of the skin defect in the lateral elbow over the weight-bearing area, a more durable soft tissue reconstruction should be performed. The size of the soft tissue defect is too large for a lateral arm skin rotational flap. A pedicled radial forearm fasciocutaneous flap would be a good option for such a reconstruction. The flap is reliable and has a long pedicle for easy flap inset. It can provide durable soft tissue coverage to this weight-bearing area of the elbow. The Allen test should be done preoperatively to evaluate the patency and adequacy of the ulnar artery system when the radial artery is sacrificed during the flap elevation to ensure an adequate blood supply to the hand.
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