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 2. A 29-year-old male sustained an open olecranon fracture of the left elbow. Fixation of the fracture was done resulting in a 60 cm2 soft tissue defect. This was covered with a medial fasciocutaneous transposition flap based on a medial upper arm perforator. The donor site was skin grafted. Recovery was uneventful, and the patient's ROM at the elbow was recorded as 100° 8 months postoperatively ().