Should a free flap be done before any surgery?

I did arthrodesis of this terrible elbow. Any critics of this procedure?

To manage the patient holistically in a biopsychosocial manner, would suggest you request the opinion and expertise of a Liaison Psychiatrist . I am not based in India ,otherwise would have been happy to help. Best wishes .  

Nice case. Looked difficult... The procedure used is probably the best and the more secure. Hard to say if there was an option for TER?

Obviously, this seems to be the ultimate solution. 

I agree with the only option to perform an artrodesis. With the quality of soft tissues and the severe loss of bone any attempt of reconstruction would be only a surgical exercise. Nicely done, congrats.

This is the best solution for this elbow. Hinged prosthesis would be a possibility (an academic possibility) but with the condition of soft tissues and the long term potential problems with shaft fractures fusion is the best solution. Strong, stable and functional within the own limitations. Great work.

free flap and after 3 months a Morey type prosthesis

I feel an arthrodesis is an easier and safer option in this case

arthrodesis in a real disabiliyty; consolidation is difficult at elbow;  sure iitis saffer if it was prior infection; easy  (for the surgeon?) is not recevable , dear Raju

I think elbow arthrodesis by ilizarof through minimal insision