The brachioradialis muscle flap: anatomy, flap variation, modes of application

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. The brachioradialis muscle is a secondary flexor of the elbow. With planning at the outset of the procedure, the brachioradialis muscle can provide adequate surface area for coverage of the deep neurovascular structures. 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.