Skip to main content
SpringerLink
Log in

Elbow coverage by the descending superficial radial artery flap: a clinical series and literature review

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Soft tissue coverage of the posterior aspect of the elbow requires thin and flexible flaps to adapt to movements without constraining them. The authors report a clinical series of reconstruction by the descending superficial radial artery (DSRA) flap, a proximal forearm perforator flap which use is rarely reported in the literature.

Methods

Seven patients with a mean age of 50 years (range 24–88 years) were treated for a posterior elbow defect using the DSRA flap with an adipofascial pedicle. The flap was tunneled to the defect in the subcutaneous tissue or raised using the racket-like technique to avoid any pedicle compression.

Results

The mean follow-up was 3.3 months (range 1–12 months). A partial necrosis of the skin paddle occurred in an 88-year-old patient. In the other cases, the flap evolution was straightforward. At the last follow-up, the appearance of the flaps was satisfactory in terms of color, texture, and thickness. No complications were observed at the donor site.

Conclusion

The DSRA flap with an adipofascial pedicle is a simple, reliable, and reproducible method for reconstruction of small to moderate-sized defect on the posterior aspect of the elbow. Its use is easier for defects on the posterolateral side, but it can reach the medial olecranon.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Data availability

No datasets were generated or analysed during the current study.

References

  1. Gandolfi S, Auquit-Auckbur I, Poirot Y, Bonmarchand A, Mouton J, Carloni R, Nseir I, Duparc F. Focus on anatomical aspects of soft tissue coverage options in elbow reconstruction: an updating review. Surg Radiol Anat. 2018;40:943–54.

    Article  PubMed  Google Scholar 

  2. Tiengo C, Macchi V, Porzionato A, Stecco C, Parenti A, Bassetto F, De Caro R. The proximal radial artery perforator flap (PRAP-flap): an anatomical study for its use in elbow reconstruction. Surg Radiol Anat. 2007;29:245–51.

    Article  PubMed  Google Scholar 

  3. Baus A, Bich CS, Grosset A, de Rousiers A, Duhoux A, Brachet M, et al. Medical and surgical management of lower extremity war-related injuries Experience of the French Military Health Service (FMHS). Ann Chir Plast Esthet. 2020;65:447–78.

    Article  CAS  PubMed  Google Scholar 

  4. Patel KM, Higgins JP. Posterior elbow wounds: soft tissue coverage options and techniques. Orthop Clin N Am. 2013;44:409–17.

    Article  Google Scholar 

  5. Ho AM, Chang J. Radial artery perforator flap. Am J Hand Surg. 2010;35:308–11.

    Article  Google Scholar 

  6. Kimura T, Ebisudani S, Osugi I, Inagawa K. Anatomical analysis of cutaneous perforator distribution in the forearm. Plast Reconstr Surg Glob Open. 2017;6: e1550.

    Article  Google Scholar 

  7. Fulchignoni C, Rovere G, Greco T, Perisano C, Smakaj A, Fidanza A, Rocchi L, Pataia E. Versatility of the perforator radial artery flap in the reconstruction of the upper limbs and comparison of the outcomes with the “classic” radial flap, a retrospective study. J Orthop. 2023;44:17–21.

    Article  PubMed  Google Scholar 

  8. Lamberty BGH, Cormack GC. The forearm angiotomes. Br J Plast Surg. 1982;35:4.

    Article  Google Scholar 

  9. Lamberty BGH, Cormack GC. The antecubital fascio-cutaneous flap. Br J Plast Surg. 1983;36:428–33.

    Article  CAS  PubMed  Google Scholar 

  10. Camuzard O, Foissac R, Clerico C, Fernandez J, Balaguer T, Ihrai T, et al. Inferior cubital artery perforator flap for soft-tissue coverage of the elbow: anatomical study and clinical application. J Bone Joint Surg Am. 2016;98:457–65.

    Article  PubMed  Google Scholar 

  11. Magden OIO, Arman C, Atabey A. An anatomical study of the inferior cubital artery. Eur J Plast Surg. 1997;20:24–6.

    Article  Google Scholar 

  12. Van Landuyt K, De Cordier BC, Monstrey SJ, Blondeel PN, Tonnard P, Verpaele A, et al. The antecubital fasciocutaneous island flap for elbow coverage. Ann Plast Surg. 1988;41:252–7.

    Article  Google Scholar 

  13. Duteille F, Rocchi L, Dautel G, Merle M. Le lambeau antécubital : intérêt dans les pertes de substance du coude. Etude anatomique et expérience de cinq cas cliniques. Ann Chir Plast Esthét. 2001;46:18–22.

    Article  CAS  PubMed  Google Scholar 

  14. Bich CS, Brachet M, Baus A, Duhoux A, Duhamel P, Bey E. The, “racket-like” flap: method to increase the reliability of the sural neuro-cutaneous flap. Ann Chir Plast Esthet. 2020;65:300–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hand and Upper Extremity Surgery, Edouard Herriot Hospital, 5 Place d’Arsonval, 69003, Lyon, France

    Robin Fauconnet, Arthémon Heitz, Arnauld Walch, Thibault Druel, Aram Gazarian & Laurent Mathieu

  2. Department of Hand and Upper Extremity Surgery, Saint-Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France

    Adeline Cambon

  3. Department of Orthopedic, Trauma and Reconstructive Surgery, Percy Military Hospital, 101 Avenue Henri Barbusse, 92140, Paris, Clamart, France

    Laurent Mathieu

  4. Department of Surgery, French Military Health Service Academy, 1 Place Alphonse Laveran, 75005, Paris, France

    Laurent Mathieu

  5. Military Biomedical Research Institute (IRBA), 1 Place Général Valérie André, 91220, Brétigny-Sur-Orge, France

    Laurent Mathieu

Authors
  1. Robin Fauconnet
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arthémon Heitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arnauld Walch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thibault Druel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aram Gazarian
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Adeline Cambon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Laurent Mathieu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

A.C-B., A.G., and L.M. operated the patients. R.F., A.H., and T.D. collected the data. A.W. and L.M. supervised the study and analyzed the data. R.F. and L.M. and wrote the manuscript.

Corresponding author

Correspondence to Laurent Mathieu.

Ethics declarations

Ethics approval

This study was approved by our review board.

Consent for publication

Informed consent was obtained from all individual participants included in the study.

Competing interest

The authors declare no competing interests.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fauconnet, R., Heitz, A., Walch, A. et al. Elbow coverage by the descending superficial radial artery flap: a clinical series and literature review. Eur J Trauma Emerg Surg (2024). https://doi.org/10.1007/s00068-024-02527-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00068-024-02527-6

Keywords

Search

Navigation