Arch Hand Microsurg.  2020 Sep;25(3):232-237. 10.12790/ahm.20.0027.

Reconstruction of Elbow Joint and Soft Tissue Defect with Anterolateral Thigh Flap and Total Elbow Replacement: A Case Report

• Park HS
• Kim DJ
• Hwang JI

• KMID: 2505905
• DOI: http://doi.org/10.12790/ahm.20.0027

Abstract

Soft tissue and bone defect due to the machinery penetrating injury of elbow joint are a rare and challenging problem for reconstructive surgeons. After reconstructing soft tissue with anterolateral thigh (ALT) flap and external fixator, the authors planned restoration of elbow function using total elbow replacement (TER). Finally, the patient regained the soft tissue reconstruction and the motion of the elbow using TER, and satisfied with the clinical results. Therefore, the authors present the successful case of ALT flap and TER to treat the machinery penetrating the injury of the elbow.

Keyword

Open Fractures; Surgical flaps; Total elbow replacement

Figure

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  Fig. 1. Plain radiograph (A) and computed tomography (B) showed a severely comminuted fracture of the distal humerus. (C) Penetrating injury showed both medial and lateral soft-tissue defect with severely contaminated status. Written informed consent for publication of the clinical images was obtained from the patient.

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  Fig. 2. Postoperative radiograph showed external fixator with antibiotic cement block. Written informed consent for publication of the clinical images was obtained from the patient.

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  Fig. 3. Postoperative computed tomography angiogram showed an intact brachial artery. Written informed consent for publication of the clinical images was obtained from the patient.

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  Fig. 4. (A) Previously injured profunda brachii artery was used as a recipient artery. (B) Postoperative status of anterolateral thigh flap. Written informed consent for publication of their clinical images was obtained from the patient.

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  Fig. 5. (A, B) Intraoperatively, posterolateral approach was utilized under the base of the ALT flap for total elbow replacement (TER). (C, D) Postoperative radiograph of TER. Written informed consent for publication of the clinical images was obtained from the patient.

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  Fig. 6. Radiological and clinical outcome at 1-year follow-up. (A, B) Plain radiographs showed no radiological loosening. (C, D) The arc of flexion–extension was 0° to 110°. (E, F) The arc of pronation–supination was 90° to 70°. Written informed consent for publication of the clinical images was obtained from the patient.

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