PMC4903136_01
(a) A squamous cell carcinoma measuring 5 x 4 cm over the medial elbow of a 75-year-old female. (b) Defect after resection: the brachial artery, median nerve, ulnar nerve, and elbow joint are exposed. The humeral epicondyle together with the origins of the flexor carpi ulnaris, flexor carpi radialis, and pronator teres was resected. (c) The flexor carpi ulnaris and flexor carpi radialis muscles were transposed to cover the defect and skin grafted. (d) Postoperative result after 4 months.
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fig2
To avoid prolonged operative time, the defect was covered with pedicled FCR and FCU muscles (Figure 2).
Perforator-based transposition flap. ((a), (b)) A 29-year-old man sustained an open olecranon fracture for which plate fixation was done. ((c), (d)) A proximally based medial forearm fasciocutaneous transposition flap was used to cover the elbow defect. (e) Postoperative result in 1 year. The donor site defect was skin grafted.
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fig3
Recovery was uneventful, and the patient's ROM at the elbow was recorded as 100  8 months postoperatively (Figure 3). 
Pedicled lateral abdominal perforator flap. ((a), (b)) 30-year-old male with fixed flexion deformity of the elbow and exposed plate. He had traumatic brachial plexus and brachial artery injuries. (c) Defect after removal of the implant. (d) A pedicled lateral abdominal perforator flap was used to cover the defect.
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fig4
Due to the ankylosis and previous brachial artery injury exploration of vessels for free tissue transfer was difficult; therefore lateral abdominal perforator flap was used to cover the defect after implant removal (Figures 4 and 5).
Same patient as in Figure 4 in 10 months postoperatively with 70  elbow range of movement, similar to preop.
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fig5
Due to the ankylosis and previous brachial artery injury exploration of vessels for free tissue transfer was difficult; therefore lateral abdominal perforator flap was used to cover the defect after implant removal (Figures 4 and 5).
(a) Open fracture of the posterior elbow in a 26-year-old male. (b) A left free anterolateral thigh flap was used to resurface the soft tissue defect. (c) Postop result in 8 months.
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fig6
The large defect was resurfaced with a free ALT fasciocutaneous flap with a cuff of vastus lateralis muscle (Figure 6).