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Case Reports
. 2021 Mar 17:34:100463.
doi: 10.1016/j.tcr.2021.100463. eCollection 2021 Aug.

The use of the anterolateral thigh vascular free flap in complex open elbow fractures after major trauma - An illustrated report of an interesting case

Efstratios Gerakopoulos  1 , Toby Colegate-Stone  1 , Edmund Fitzgerald O'Connor  1 , Victoria Rose  1
Affiliations
Case Reports

The use of the anterolateral thigh vascular free flap in complex open elbow fractures after major trauma - An illustrated report of an interesting case

Efstratios Gerakopoulos et al. Trauma Case Rep. .

Erratum in

Abstract

Major trauma may result in severe open elbow fractures with significant soft tissue injury and skin loss. Reconstruction of those defects can be complicated and inadequate cover can result in severely limited functional outcome. The free anterolateral thigh flap (ALT) is one of the ways to reconstruct those defects. Its utilisation in severe complex open elbow fractures is recently being increased due to its advantages. The purpose of this article is to present an interesting case where the ALT flap was used with success in a challenging situation of a severe elbow bony, ligamentous and soft tissue injury. Our case has demonstrated that the ALT flap presents an effective method in treating successfully severe open elbow fractures, and its advantages include 1)large amount of available skin and subcutaneous tissue for coverage of the elbow joint without creating strictures, 2)potential of using the vascularised vastus lateralis muscle to minimise the residual dead space in order to prevent infection and as a vascular bed for nerve grafting and 3) the ability to harvest fascia lata grafts and use them to reconstruct ligamentous and tendinous injuries. We recommend the use of the vascularised ALT flap when treating severe open elbow fractures.

Keywords: Elbow; Free flaps; Ligament reconstruction; Open fractures.

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Figures

Fig. 1
Fig. 1
AP radiograph of the left elbow at presentation.
Fig. 2
Fig. 2
Clinical picture of the left elbow on the day of admission.
Fig. 3
Fig. 3
Clinical picture of the left elbow after initial surgical management.
Fig. 4
Fig. 4
Bony tunnels' preparation during definitive ligamentous reconstruction.
Fig. 5
Fig. 5
The fascia lata graft was passed through the tunnels and tensioned in order to reconstruct the lateral collateral ligament.
Fig. 6
Fig. 6
The skin paddle was prepared and the skin defect was closed without tension.
Fig. 7
Fig. 7
AP radiograph at 1 year post-operative follow up.
Fig. 8
Fig. 8
Lateral radiograph at 1 year post-operative follow up.
Fig. 9
Fig. 9
Clinical picture of the left elbow at 1 year post-operative follow up.
See this image and copyright information in PMC

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