Treatment Of Complicated Major Trauma Of The Elbow And Forearm By The Musculo-Cutaneous Latissimus Dorsi Flap With A Skeletonized And Denervated Pedicle

摘要

Major complicated injuries of the upper limb that once led to amputation are now being successfully salvaged. The goals of treatment in such cases are rigid fixation of fractures, reliable stable coverage of important structures, preservation of function and an acceptable cosmetic result. There is no consensus in the literature regarding the treatment strategy of upper limb trauma with damage distal to the olecranon. The latissimus dorsi musulocutaneous flap is often used for upper limb reconstruction for functional elbow restoration following different sorts of injures [1-5].We report two cases of major trauma of the elbow and forearm distal to the olecranon, that have been successfully treated by skeletonized, pedicled, denervated latissimus dorsi musculo-cutaneous flaps. Introduction Major complicated injuries of the upper limb that once led to amputation are now being successfully salvaged. The goals of treatment in such cases are rigid fixation of fractures, reliable stable coverage of important structures, preservation of function and an acceptable cosmetic result. There is no consensus in the literature regarding the treatment strategy of upper limb trauma with damage distal to the olecranon. The latissimus dorsi musulocutaneous flap is often used for upper limb reconstruction for functional elbow restoration following different sorts of injures [1-5].We report two cases of major trauma of the elbow and forearm distal to the olecranon, that have been successfully treated by skeletonized, pedicled, denervated latissimus dorsi musculo-cutaneous flaps. Patients and Methods Case 1A 24 year old male was admitted to our hospital after being involved in a motor vehicle accident. At admission he was diagnosed as suffering from a crush injury of his right arm with an open comminuted fracture and dislocation of the right proximal radius and ulna (as seen in figure 1), and fractures of metacarpal bones 4-5.