Le lambeau antécubital est un lambeau fasciocutané basé sur la première collatérale proximale de l'artère radiale. Ce lambeau a été décrit en 1983 par Lamberty et Cormack mais n'a pas connu un grand essor. Les auteurs ont réalisé une étude anatomique sur huit membres injectés. Ils mettent en évidence une constance de l'artère nourricière du lambeau. En revanche, ils n'ont pas retrouvé d'anastomoses avec un réseau distal qui aurait permis une levée du lambeau à pédicule distal. L'utilisation de ce lambeau dans les pertes de substance du coude est illustrée par une série de cinq cas cliniques. Ce lambeau est apparu aux auteurs comme fiable, aisé et de dissection rapide. De plus il est sensible et possède un arc de rotation intéressant. Le prélèvement peut se faire sous la forme d'une palette cutanée distale en îlot qui a l'avantage de diminuer la rançon cicatricielle. L'intérêt du lambeau antécubital par rapport aux autres lambeaux pédiculés est ensuite discuté. En conclusion il apparaît que ce lambeau, peu connu, possède de réels avantages et mérite de faire partie des alternatives du chirurgien plasticien face à une perte de substance du coude.

The antecubital flap: the advantages of the antecubital fasciocutaneous flap for elbow coverage. An anatomical investigation and a study of five cases.

The antecubital flap is a fasciocutaneous strip that has its blood supply provided by the first proximal collateral of the radial artery. This flap was described for the first time in 1983 by Lamberty and Cormack, but it has not been widely used and there have been only a few reports in the literature concerning this procedure. The aim of the present investigation was to demonstrate via an anatomical study and a report on five cases the viability of the various anatomical features of this cutaneous flap, and also its positive contribution to elbow reconstruction. The anatomical study involved eight fresh cadavers (eight upper limbs). An injection of colored prevulcanized latex was made in the humeral artery in the lower third of the arm. The aim was to determine which artery provided blood supply to the flap, its anatomical location, and also to look for possible distal anastomoses which would permit a distal pedicled flap to be removed. Contrary to the findings of other authors, in the present study it was found that the vessel providing blood to the antecubital flap always branched off from the radial artery. However, no anastomoses with distal vascularization were detected, which would have permitted a distal pedicled flap to be obtained. The use of the antecubital flap for elbow coverage was then illustrated by five clinical cases of soft tissue defects of the elbow. This method was found to be reliable, practical, and the flap could be rapidly dissected. Moreover, this particular technique is sensitive, and has an interesting rotational arc. The distal cutaneous island flap has the advantage of limiting scar tissue. A comparison between the antecubital flap and other pedicled flaps has then been made. In conclusion, it appears that this little-known procedure has definite advantages, and that it should be included in the range of surgical techniques that are available for soft tissue reconstruction in the case of elbow defects.