Case report
Reconstruction of elbow region defects using radial collateral artery perforator (RCAP)-based propeller flaps

https://doi.org/10.1016/j.bjps.2012.03.013Get rights and content

Summary

Perforator-based propeller flaps permit flap rotation up to 180°. This ability to transfer skin from one longitudinal axis to another has led to the increasing use of perforator-based propeller flaps in extremity reconstruction, especially lower-extremity reconstruction. However, the application of perforator-based propeller flaps to upper-extremity reconstruction is still limited. This article reports two cases of successful reconstruction of elbow region defects with radial collateral artery perforator (RCAP)-based propeller flaps.

The elbow region has a variety of perforators available for perforator-based propeller flap reconstruction. Among them, the RCAP seems to be one of the most reliable options. This is because there are less anatomical variations of perforators' location on the lateral upper arm than on the medial upper arm. By using an RCAP perforator as a flap pedicle, the small-to-medium sized defects (<6 cm in diameter) around elbow regions can be closed primarily without skin grafts.

Section snippets

Case 1

A 71-year-old man presented with an elbow soft-tissue defect following olecranon bursitis (Figure 1(a)). An RCAP-based propeller flap, measuring 13 × 5 cm, was planned to cover the defect, measuring 10 × 5 cm after the bursal cyst excision. The locations of perforators were confirmed preoperatively by using acoustic Doppler. The RCAP was dissected above the deep fascia while preserving the perforators. A perforator that penetrated the deltoid tendon and a perforator that arose from the lateral

Discussion

The profunda brachial artery is the first major branch of the brachial artery (Figure 3). This artery closely follows the radial nerve, and is divided into the anterior branch (anterior RCA) and posterior branch (posterior RCA). This bifurcation is located on average 10 cm (range: 7.5–11.4 cm) proximal to the prominence of the lateral epicondyle.6 Then the posterior RCA runs along the lateral intermuscular septum between the brachioradialis muscle anteriorly and the triceps muscle posteriorly,

Disclosure

None of the authors has a financial interest to declare in relation to the content of this article.

Funding

None.

Conflicts of interest

None declared.

Ethical approval

Not required.

References (9)

There are more references available in the full text version of this article.

Cited by (0)

View full text