A 40-year-old male was a front seat passenger in a car involved in a road traffic accident. He sustained fractures of the left 1st to 6th ribs, a left sided pneumothorax, pneumomediastinum, left scapula fracture, dislocation of the left little finger PIPJ as well as a crush injury of the left elbow with open fracture of the left humerus and proximal ulna. A chest tube was inserted and the little finger reduced. The elbow wound underwent debridement followed by external fixation and negative pressure dressing. Internal fixation of the humerus and ulna and soft tissue coverage with a free ALT flap were performed 13 days following injury. Nineteen months postoperatively active elbow motion was 115° (range, 15° to 130°) ().
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°.