Case 1. An 80-year-old female with multiple comorbidities including ischemic heart disease and chronic renal failure developed an ulcerating squamous cell carcinoma of her right elbow measuring 7 × 5 cm. Radiological studies showed no bony or joint involvement. The resultant wide excision included the skin, subcutaneous tissue, and underlying muscle, with a defect size of 75 cm2 exposing the elbow joint capsule and ulnar nerve. To avoid prolonged operative time, the defect was covered with pedicled FCR and FCU muscles (). The postoperative course was uneventful and in 10 months postoperatively the range of motion (ROM) at the elbow was 90°.
Case 4. A 35-year-old male sustained loss of anterior elbow soft tissue in a workplace accident. This exposed underlying tendons, vessels, and nerves. The large defect was resurfaced with a free ALT fasciocutaneous flap with a cuff of vastus lateralis muscle (). In 12 months postoperatively, the patient has excellent contour and 110° ROM.