Background: Soft tissue defects about the elbow with concurrent ligamentous instability can be challenging to treat. Methods: We present a case report of a lateral elbow wound that resulted in lateral ulnar collateral ligament deficiency and posterolateral elbow instability. Results: We describe our technique of a modified brachioradialis rotational flap, in which the muscle is rotated to cover the soft tissue defect, while the vascularized brachioradialis tendon is used to simultaneously reconstruct the lateral ulnar collateral ligament. This procedure successfully restored posterolateral elbow stability at the time of wound coverage. Conclusion: Elbow soft tissue defects with associated ligamentous injuries can be treated using a modification of the brachioradialis rotational flap.
StevanovicMSharpeF.Soft-tissue coverage of the elbow. Plast Reconstr Surg. 2013;132(3):387e-402e. doi:10.1097/PRS.0b013e31829ae29f.
2.
ChoudryUHMoranSLLiS, et al. Soft-tissue coverage of the elbow: an outcome analysis and reconstructive algorithm. Plast Reconstr Surg. 2007;119(6):1852-1857. doi:10.1097/01.prs.0000259182.53294.67.
3.
JensenMMoranSL.Soft tissue coverage of the elbow: a reconstructive algorithm. Orthop Clin North Am. 2008;39(2):251-264. doi:10.1016/j.ocl.2007.12.009.
RohrichRJIngramAEJr.Brachioradialis muscle flap: clinical anatomy and use in soft-tissue reconstruction of the elbow. Ann Plast Surg. 1995;35(1):70-76. http://www.ncbi.nlm.nih.gov/pubmed/7574291. Accessed March 28, 2019.
6.
LeversedgeFJCaseyPJPayneSH, et al. Vascular anatomy of the brachioradialis rotational musculocutaneous flap. J Hand Surg Am. 2001;26(4):711-721. doi:10.1053/jhsu.2001.26200.
7.
SangerJRYeZYousifNJ, et al. The brachioradialis forearm flap: anatomy and clinical application. Plast Reconstr Surg. 1994;94(5):667-674. http://www.ncbi.nlm.nih.gov/pubmed/7938290. Accessed March 28, 2019.
8.
MorreyBFAnKNChaoE.Functional Evaluation of the Elbow. Philadelphia, PA: W.B. Saunders; 1993.
9.
BinnsMKuehKAPhoRW.Brachioradialis forearm flap in a case of traumatic bone and skin loss at the elbow. J Hand Surg Br. 1990;15(3):317-319.
10.
CampCLFuMJahandarH, et al. The lateral collateral ligament complex of the elbow: quantitative anatomic analysis of the lateral ulnar collateral, radial collateral, and annular ligaments. J Shoulder Elbow Surg. 2019;28(4):665-670. doi:10.1016/j.jse.2018.09.019.
11.
GongHSKimJKOhJH, et al. A new technique for lateral ulnar collateral ligament reconstruction using the triceps tendon. Tech Hand Up Extrem Surg. 2009;13(1):34-36. doi:10.1097/BTH.0b013e3181886765.
