• Faisal Ashfaq


Background: Flap coverage is superior to graft for elbow defects secondary to burns to preserve range of motion. Reverse lateral arm flap is one of the few local options available with good colour and contour match and no sacrifice of major blood vessel. There has been few clinical series describing its use. The aim of this study is to describe its usefulness in both acute and post burn deformities for coverage of elbow defects. Methods: Patient's record with burns and elbow defects covered with this flap was reviewed for this descriptive case series. Results: Six patients; three males and three females, underwent one stage reverse lateral arm flap for elbow defects from February 2012 to March 2013. Two patients had acute electrical burns, one had acute flame burn and three patients had post burn antecubital contractures. All flaps survived completely providing stable coverage and good range of motion after three months. Conclusion: reverse lateral arm flap must be kept in the armamentarium of a plastic surgeon for coverage of elbow defectsKeywords: Reverse lateral arm flap, Elbow, Burns, Contracture


Katsaros J, Shusterman M, Beppu M, Banis JC Jr, Acland RD. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg. 1984;12:489–500.

Kleinman WB, O'Connell SJ. Effects of the fasciocutaneous radial forearm flap on vascularity of the hand. J Hand Surg Am 1993;18:953–8

Balakrishnan G, Kumar BS, Hussain SA. Reverse-flow posterior interosseous artery flap revisited. Plast Reconstr Surg 2003;111:2364–9.

Kostakoglu N, Kecik A. Upper limb reconstruction with reverse flaps: a review of 52 patients with emphasis on flap selection. Ann Plast Surg 1997;39:381–9

Song R, Song Y, Yu Y, Song Y. The upper arm free flap. Clin Plast Surg 1982;9:27–35.

Maruyama Y, Takeuchi S. The radial recurrent fasciocutaneous flap: reverse upper arm flap. Br J Plast Surg 1986;39:458–61.

Culbertson JH, Mutimer K. The reverse lateral upper arm flap for elbow coverage. Ann Plast Surg 1987;18:62–68.

Lai CS, Lin SD, Chou CK, Tasi CC. The reverse lateral arm flap, based on the interosseous recurrent artery, for cubital fossa burn. Br J Plast Surg 1994;47:341–5.

Turegun M, Nisanci M, Duman H, Aksu M, Sengezer M. Versatility of the reverse lateral arm flap in the treatment of postburn antecubital contractures. Burns 2005;31:212–6.

Lai CS, Tsai CC, Liao KB, Lin SD. The reverse lateral arm adipofascial flap for elbow coverage. Ann Plast Surg 1997;39:196–200.

Tung TC, Wang KC, Fang CM, Lee CM. Reverse pedicled lateral arm flap for reconstruction of posterior soft-tissue defects of the elbow. Ann Plast Surg 1997;38:635–41.

Morrison CS, Sullivan SR, Bhatt RA, Chang JT, Taylor HO. The pedicled reverse-flow lateral arm flap for coverage of complex traumatic elbow injuries. Ann Plast Surg 2013;71:37–9.

Middleton RW, Varian JP. Tourniquet paralysis. Aust NZ J Surg 1974;44:124–8.

Klenerman L. Tourniquet paralysis. J Bone Joint Surg 1983;65:374–5.