Abstract
Soft tissue reconstruction around the elbow is challenging due to the need for durable yet pliable coverage that preserves joint mobility and function. We present the case of a 56-year-old gentleman with a chronic elbow wound secondary to osteomyelitis. Following debridement, the defect was reconstructed using a posterior ulnar recurrent artery perforator (PURAP) flap designed in a propeller style. Unlike previous reports that have described PURAP flaps based on arm perforators, this case uniquely utilised perforators arising from the forearm. This forearm-based approach offers several advantages, including reduced donor-site morbidity, and avoidance of dissection near the ulnar nerve. This case highlights the versatility and safety of the forearm-based PURAP flap for elbow reconstruction. Level of evidence: Level 5.