The anconeus muscle flap: Its anatomy and clinical application

The arterial anatomy, coverage area, and potential donor site morbidity of the anconeus muscle flap are described. Using 17 cadaveric upper extremitie s, we investigated the muscle's arterial anatomy in 12 specimens and define d the coverage area of the anconeus flap in 5 specimens. We also reviewed t he records of 9 patients who underwent a pedicle anconeus muscle flap for e lbow coverage to assess clinical results of the procedure. The anconeus mus cle is supplied from 3 arterial pedicles: the recurrent posterior interosse us artery, the medial collateral artery, and the posterior branch of the ra dial collateral artery. The recurrent posterior interosseus artery and the medial collateral artery were present in all dissected cadavers and consist ently anastomosed with each other underneath the anconeus muscle. By harves ting the muscle on the medial collateral artery, the anconeus muscle flap c an be expected to cover a 7.3 cm(2) defect over the radiocapitellar joint, a 6.1 cm(2) defect over the distal triceps tendon, and a 7.2 cm(2) defect o ver the olecranon. In this series, none of the patients experienced loss of elbow motion, stability, or extension strength. The results of this study indicate that the anconeus can be harvested with minimal risk of morbidity and provides effective coverage for soft tissue defects of the elbow. Copyr ight (C) 1999 by the American Society for Surgery of the Hand.