PMC9302009_01
Left elbow defect following wide local excision of a Merkel cell carcinoma lesion.
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The resulting defect measured 5 x 5 cm over the olecranon (Figure 1).
Reverse lateral arm flap design along the axis of the lateral intermuscular septum, extending from the deltoid insertion to the lateral epicondyle. (*) Audible doppler signal of the targeted perforating vessels.
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The skin island design was centered over the lower third, measuring 15 x 8 cm (Figure 2).
Reverse lateral arm flap pedicle dissection (Arrow) and sparing of the radial nerve (*) and posterior cutaneous nerve of the arm (**).
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The pedicle was dissected free from the surrounding tissue and nerves, protecting the radial nerve and posterior cutaneous nerve of the arm (Figure 3).
Reverse lateral arm flap rotation and inset.
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The overlying skin bridge was divided to avoid compression on the pedicle and the donor site was closed primarily without tension (Figure 4).
Recovery of elbow range of motion was shown at six months follow-up. (a) Full flexion (b) Full extension.
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Recovery of full elbow range of motion was achieved six months post-surgery with physiotherapy (Figure 5).