Key to the Success of a Pedicled Latissimus Dorsi Musculocutaneous Flap in Patients with Soft Tissue Defects Around the Elbow Complicated by Trauma

Objective: The purpose of this investigation was to evaluate the effectiveness of a pedicled latissimus dorsi musculocutaneous flap (PLDMF) applied to trauma-complicated large soft tissue defects in the upper extremity up to the elbow area.
Materials and Methods: Six patients who received a PLDMF at our clinic for a traumatic soft tissue defect around the elbow between 2014 and 2019 were included in this prospective follow-up, retrospective cohort-type analysis. In addition to the extent of the soft tissue defect, the length of postoperative hospitalization, follow-up, complications, and time to return to work, the patient’s demographic information was also noted. The Q-DASH questionnaire was used to assess elbow and shoulder joint range of motion (ROM) 9 months after surgery.
Results: Six male patients with an average age of 39.8±13.07 years had defects with a mean size of 272 cm2. In a patient who underwent amputation at the elbow level, a flap was used to treat an antecubital deformity after replantation in the same session. Three patients experienced hematoma in the donor location, superficial necrosis distal to the flap, and superficial infection. They were released after 14–29 days. The flaps survived in all patients, and both the Q-DASH questionnaire and shoulder and elbow joint ROM outcomes were satisfactory.
Conclusion: In complex soft tissue problems around the elbow joint that may need extensive therapy and would probably result in disability, a PLDMF can be used safely. Intraoperative Doppler ultrasonography helps prevent the most typical consequence, distal necrosis.