THE REVERSE LATERAL ARM ADIPOFASCIAL FLAP FOR ELBOW COVERAGE

The reverse lateral arm adipofascial flap covered immediately with a s kin graft has been used successfully for reconstruction of a cubital f ossa defect (caused by avulsion injury) and an exposed olecranon (resu lting from recurrent bursitis) in 2 patients. The flap is nourished by the septal perforators of the posterior radial collateral artery, whi ch in turn obtains its blood supply from the interosseous recurrent ar tery, The distal vascular pedicle should contain a sufficient amount o f subcutaneous fat and its underlying fascia to enhance the arterial i nput and the venous drainage of the flap, The primary benefit of this technique is that the thickness of the flap can be tailored to fit int o the defect, and the donor site can be closed primarily without tensi on, The advantages include satisfactory cosmetic results, a rapid one- stage procedure, no sacrifice of the main artery or local muscle, and avoidance of any long-term immobilization of the involved elbow joint.