Long-term follow-up of a case of bilateral elbow ulcers in a patient with Werner syndrome treated with pedicled radial forearm flaps.

Abstract

Werner syndrome is a rare autosomal recessive disorder caused by WRN gene mutations, leading to premature aging and genomic instability. Clinical symptoms include diabetes, skin lesions, and microvascular issues, with patients frequently developing difficult-to-heal ulcers on the distal legs, feet, and elbows. Surgical treatments, such as flap surgery, are rarely reported. We present the case of a 45-year-old male with Werner syndrome who developed refractory ulcers on both elbows. Despite conservative treatments, the ulcers persisted, leading to successful radial forearm pedicle flap surgeries. Postoperative results were favorable, with no complications, ulcer recurrence, or infections over a 16-year follow-up period. The patient maintained a full range of motion in both elbows. This case highlights the challenges of managing ulcers in Werner syndrome and the successful long-term outcomes of flap surgery, providing valuable insights into this rare condition's treatment.