Case Overview: We present the case of a 62-year-old man who had a nonhealing wound with recurrent draining sinus of the right posterior elbow secondary to failed triceps repair.

Technique: The patient was positioned in the left lateral decubitus position with the arm draped over a lateral arm holder. The posterior wound was incorporated into an extended posterior incision. Dissection from the previous procedure was then extended to the flexor carpi ulnaris/extensor carpi ulnaris/anconeus interval, which was outside the previous operative zone. The anconeus was released off the ulna distally and was carefully separated from its interval with the extensor carpi ulnaris. Care was taken to keep its attachments to the lateral epicondyle and its relative pedicles. With sufficient tissue elevation, we performed a proximal fascial release, which facilitated rotation of the anconeus over the olecranon. The flap was then inset and the skin closed.

Results: The patient's wound was healed by 3 months without any signs of recurrent drainage for the first time in more than a year. This technique, first described by Cardany et al, has been found to be an effective treatment for chronic tissue defects about the elbow, as seen in a case series published by Elhassan et al. An additional study by Choudry et al demonstrated that use of the anconeus flap over other local muscle flaps reduces postoperative morbidity.

Summary: The local pediculated anconeus flap is an effective treatment option for a chronic draining sinus of the posterior elbow with associated soft-tissue involvement.