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Soft-Tissue Coverage Options for the Elbow
The elbow has an anatomically unique soft-tissue envelope that includes substantial anterior skin, muscle, and fascia, all of which protect the median and radial nerves as well as the brachial vessels. The ulnar nerve is immediately subcutaneous and vulnerable at the medial epicondyle. The lateral and medial epicondyles and the olecranon are covered only by skin. The posterior skin of the elbow is particularly prone to soft-tissue breakdown after fracture treatment or olecranon bursitis. Timely intervention to address soft-tissue defects can help restore function and limit adverse events. This chapter reviews the treatment algorithm for reconstruction of soft-tissue defects about the elbow. The concepts of pedicle flap versus microvascular composite tissue transplant for soft-tissue and bone defects of the elbow are also discussed.