A case of severe loss of substance in the soft tissue of the elbow. Planning of surgical treatment in compliance with good clinical-care practices and medical-legal implications

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Federico Amadei
Giuseppe Basile
Maurilio Cosimo Bruno
Carlo Romano'

Keywords

elbow loss, radial brachio muscle flap, elbow reconstruction, orthoplastic, medical-legal implications

Abstract

The loss of skin substance near the elbow region with exposure of noble tissues (tendons, neuro-vascular beams and bone and articular surfaces) is a difficult challenge requiring adequate and accurate surgical reconstruction. Insufficient repair of soft tissue defects in the elbow can compromise reconstructive orthopedic surgical treatment, such as osteosynthesis, by fracture or partial or total prosthetization. It is difficult to establish the correct reparative sequence of these lesions.  This can negatively affect the functional outcomes of the whole upper limb, with reverberations also on the aesthetic level and greater representation of menomative sequelae incidents on the actual extent of the permanent posthumous patient. The first step is represented by appropriate debridement which allows the removal of all non-viable tissue. Then proceed with the choice of method of covering the loss of substance.
The elbow is one of the most complex anatomical regions from the point of view of the surgical-reconstructive strategy. It often records scarce reconstructive results, with fearful disabling reverberations and negative repercussions in the work environment. It is inevitably susceptible to deliberate medical-legal assessment.


 


The authors describe a clinical case using brachiradial muscle flap on humerus-infected pseudoarthrosis.

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