Techniques in hand & upper extremity surgery
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Tech Hand Up Extrem Surg · Jun 2010
Brachioradialis flap for coverage after elbow flexion contracture release.
Release of a chronic elbow flexion contracture such as that seen in spastic or congenital conditions may result in an anterior soft tissue defect that leaves the antecubital neurovascular structures exposed. Although the skin defect can most often be managed by local rotation or transposition flaps, protection of the deep structures requires more than a skin graft or thin flaps. ⋯ It has a robust vascular anatomy that can support a skin paddle if necessary, and there is minimal functional morbidity when it is removed. We find this technique to be a useful strategy to simplify wound closure in the antecubital fossa.
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Tech Hand Up Extrem Surg · Jun 2010
Surgical treatment of posterolateral rotatory instability of the elbow in children.
Posttraumatic instability of the elbow in children can be a very challenging problem to diagnose and treat. Posterolateral rotatory instability (PLRI) has been well described with regard to diagnosis and treatment in adults but best clinical practices are less clear for pediatric cases. ⋯ This report presents an overview of the current practice in the diagnosis and treatment of PLRI in the pediatric population. Indications for surgical treatment and step-by-step surgical instructions for both ligamentous repair and reconstruction are presented.