Flexor Carpi Ulnaris Muscle Flap for Soft Tissue Reconstruction after Total Elbow Arthroplasty

Abstract

The soft tissue at the tip of the olecranon is very thin, leading to the frequent occurrence of wound complications after total elbow arthroplasty. To cover a soft tissue defect of the elbow, the flexor carpi ulnaris muscle flap is thought to be appropriate for reconstruction of the elbow with regard to its size, location, and blood supply. We got positive clinical results, so we report our experiences of using a flexor carpi ulnaris muscle flap for soft tissue reconstruction after total elbow arthroplasty.

Soft-tissue coverage for wound complications following total elbow arthroplasty

“…Our data suggests that long-term complication rates after soft-tissue coverage of TEA are likely higher (78%). Two studies reported long-term outcomes after soft-tissue reconstruction for TEA related complications [ 2 , 9 ]. Kim et al [ 2 ] reported reoperations in 60% of the patients (3/5) treated with a pedicled radial forearm flap at a mean follow-up of 88 months.…”

“…In contrast, the reoperation rate after soft-tissue reconstruction in our cohort of older patients with rheumatoid arthritis was higher (78%). Okamoto et al [ 9 ] reported the long-term outcome of one 84-year-old female with rheumatoid arthritis that underwent soft-tissue reconstruction after TEA. At a 3-year follow-up, there were no complications.…”

“…Reports on the outcomes of soft-tissue reconstruction in the setting of TEA are limited. Studies with short-term follow-ups have shown the short-term benefits of soft-tissue reconstruction, but longer follow-up complication rates remain high, which is in line with most total elbow arthroplasties [2,3,7,9]. This study aims to assess the soft-tissue related outcomes and the arthroplasty related outcomes after soft-tissue reconstruction following TEA.…”

Notes on the Accessory Flexor Carpi Ulnaris Muscle: A Rare Supernumerary Variation

“…In light of this, FCUM flap has been performed recently due to its regular vascular supply and easy flap obtainment from this muscle. 6 Thus, an aFCUM would also be a good candidate for this procedure, despite its rarity in the general population.…”

“…1,3 Although variations of the FCUM are rare, it is a clinically significant muscle, as it can cause compression of the UN, and it can be used as a muscle flap for soft tissue reconstruction. [4][5][6] Accessory muscles of the forearm can also mimic neuromas or soft tissue tumors, and can contribute to the onset of thrombosis and syndromes such as carpal tunnel. Knowledge of these variations are important to surgery, as most of them are discovered intraoperatively 5,7 The present work reports the presence of an accessory flexor carpi ulnaris muscle (aFCUM) in a male cadaver and discusses its clinical significance.…”