Application of the Island Pedicle Latissimus Dorsi Flap for Soft Tissue Coverage of the Elbow

Abstract

Soft tissue coverage of large defects at the level of the elbow is a difficult undertaking. Superficial neurovascular elements and a thin subcutaneous covering of the osseous structures do not allow a great variety of coverage options. A systematic reconstruction scheme for tissue defects in the upper extremity, as there is for defects in the lower extremity, does not exist. Coverage of the elbow has traditionally been accomplished with local transpositional flaps or free tissue transfer. At the elbow, local flaps are more likely to be involved in the original disease process. Long operative procedures and dependence on local blood supply, difficulties inherent in free tissue transfer, can be avoided with the use of the pedicled latissimus dorsi flap. This easily tailored flap allows the coverage of large defects at the elbow level. A case series of six patients and a description of the operative technique used for a pedicled island flap of the latissimus dorsi are reported.