Background: Coverage of defects around the elbow can
be treated by a variety of procedures as skin grafts, regional
flaps, muscle flaps and free flaps. The reverse flow lateral
arm flap (LAF) is a valuable option in coverage of these
defects. The vascular basis of this flap, via the multiple
communications around the elbow between the collateral and
recurrent arteries, is consistent and reliable.
Aim of the Study: To explore the utility of the reverse
flow lateral arm flap (LAF) in management of defects around
the cubital fossa region in pediatric patients.
Patients and Methods: This work was executed at The
Menoufia University Hospitals, from October 2017 to December
2018, following our cases post-operatively for an average
one year. It entailed eight patients, six boys and two girls.
The age of our cases was from 4 to 11 years. Six patients had
post-burn contracture release defects, and 2 patients had
traumatic avulsion of antecubital skin. All the defects were
covered by the reverse-flow lateral arm flap (LAF) with skin
grafting of the donor site.
Results: All the flaps survived completely, except one
case showed distal superficial necrosis and healed spontaneously.
We applied skin graft to the flap donor site in the eight
patients. Flap size ranged from 15x7 cm. to 12x5cm. Aesthetically,
the flap and donor sites were satisfactory, and functionally,
the range of motion of elbow was very adequate. One
patient developed transient radial nerve palsy and completely
recovered by conservative treatment and physiotherapy.
Conclusion: The reverse flow lateral arm flap (LAF) is
a valuable single-stage option in coverage of defects around
the elbow. It provides reliable and stable coverage of these
defects without sacrificing major vessel or functional muscle
unit. The flap had satisfactory aesthetic and functional outcome.