"Sensory Switching" in Elbow Reconstruction

J Brachial Plex Peripher Nerve Inj. 2015 Apr 29;10(1):e30-e33. doi: 10.1055/s-0035-1549369. eCollection 2015 Dec.

Abstract

In the treatment of the soft tissue defect of the elbow, flap reconstruction is necessitated in many cases because of thinness of soft tissue at this region. In addition, reacquirement of tactile sensation is desirable because of the anatomical and specific functions of the elbow. Of three cases treated for elbow defects, one was reconstructed with a pedicled island forearm flap containing the lateral cutaneous nerve of the forearm, another was reconstructed with a venoneuro-accompanying artery fasciocutaneous flap (VNAF flap) containing the basilic vein, and the third with the VNAF flap containing the cephalic vein. The three cases demonstrated a sudden change of sensory territory 4 to 6 months after surgery, which was confirmed by touching the reconstructed region with patients' eye-closed: from its original territory to the elbow in a "switching"-like action. Here we describe and discuss the concept of "sensory switching."

Keywords: elbow reconstruction; sensory nerve; sensory reconstruction; sensory switching; sensory territory.