scholarly journals Safe Osteocutaneous Radial Forearm Flap Harvest with Prophylactic Internal Fixation

2011 ◽  
Vol 4 (3) ◽  
pp. 129-136 ◽  
Author(s):  
Yelizaveta Shnayder ◽  
Terance T. Tsue ◽  
E. Bruce Toby ◽  
Andreas H. Werle ◽  
Douglas A. Girod
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Pathological Fracture ◽  
Plate Fixation ◽  
Radius Fracture ◽  
Head And Neck Reconstruction ◽  
Microvascular Reconstruction ◽  
Radial Forearm Free Flap ◽  
Fixation Technique ◽  
Radial Forearm

We studied the efficacy of prophylactic plate fixation technique and a modified harvest of the osteocutaneous radial forearm free flap (OCRFFF) to minimize the incidence of postoperative donor radius pathological fracture. We retrospectively studied of the first 70 consecutive patients undergoing OCRFFF harvest by the University of Kansas Head and Neck Microvascular Reconstruction Team. Mean follow-up was 13 months. One of two patients undergoing OCRFFF harvest without prophylactic fixation developed a pathological radius fracture. The 68 subsequent OCRFFF patients underwent prophylactic fixation of the donor radius, and none developed a symptomatic radius fracture. Five of 68 patients did have a radiographically visible fracture requiring no intervention. The plate fixation technique was further modified to exclude monocortical screws in the radius bone donor defect (subsequent 39 patients), without any further fractures detected. One patient required forearm hardware removal for an attritional extensor tendon tear. The described modified OCRFFF harvest and prophylactic plate fixation technique may eliminate postoperative pathological fracture of the donor radius. Donor morbidity is similar to that of the fasciocutaneous radial forearm free flap , affording safe use of OCRFFF in head and neck reconstruction.

scholarly journals Radial forearm free flap in a patient with an unusual radial artery variation: a case report

2021 ◽  
Vol 48 (6) ◽  
pp. 646-650
Author(s):  
Giulio Menichini ◽  
Sara Calabrese ◽  
Nicola Alfonsi ◽  
Marco Innocenti
Keyword(s):  
Head And Neck ◽  
Radial Artery ◽  
Free Flap ◽  
Verrucous Carcinoma ◽  
The Body ◽  
Head And Neck Reconstruction ◽  
Soft Tissue Reconstruction ◽  
Radial Forearm Free Flap ◽  
Skin Paddle ◽  
Radial Forearm

Head and neck reconstruction poses unique challenges in rehabilitating surgical defects in terms of integrity, function, and form. The radial forearm free flap (RFFF) has been widely used for defect coverage, especially in the head and neck area, but its versatility allows it to be used for soft-tissue reconstruction in various parts of the body. The vascular features of the flap are quite constant and reliable. Nevertheless, abnormalities of the forearm vascular tree have been described over the decades. We report a case of intraoral reconstruction after verrucous carcinoma recurrence in a 74-year-old woman with an unusual forearm flap, which we called the median forearm free flap, based on a median branch of the radial artery that was preoperatively detected using handheld Doppler ultrasonography. The distally located skin paddle was predominantly supplied by the aberrant median vessel with its perforators. The flap was thus safely harvested with this atypical pedicle. Successful reconstruction of the intraoral defect was achieved, with an uneventful postoperative course.

The radial forearm free flap for head and neck reconstruction: A review

1994 ◽  
Vol 168 (5) ◽  
pp. 446-450 ◽  
Author(s):  
Gregory R.D. Evans ◽  
Mark A. Schusterman ◽  
Stephen S. Kroll ◽  
Michael J. Miller ◽  
Gregory P. Reece ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Radial Forearm Free Flap ◽  
Neck Reconstruction ◽  
Radial Forearm

Versatility of the Radial Forearm Free Flap in Head and Neck Reconstruction. A Study of 58 Cases

2020 ◽  
Vol 71 (5) ◽  
pp. 275-280
Author(s):  
Eduardo Ferrandis Perepérez ◽  
María Antón Almero ◽  
Alberto Guillén Martínez ◽  
Rafael Martínez Hervás ◽  
Ángel Pla Mocholí
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Radial Forearm Free Flap ◽  
Neck Reconstruction ◽  
Radial Forearm

Donor-Site Outcomes for the Osteocutaneous Radial Forearm Free Flap

2017 ◽  
Vol 33 (08) ◽  
pp. 544-548 ◽  
Author(s):  
Adam Satteson ◽  
Joshua Waltonen ◽  
Zhongyu Li ◽  
Ethan Wiesler ◽  
Peter Apel ◽  
...  
Keyword(s):  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Graft Loss ◽  
Radius Fracture ◽  
Head And Neck Reconstruction ◽  
Complication Rates ◽  
Radial Forearm Free Flap ◽  
Hardware Complications ◽  
Radial Forearm

Background This study sought to characterize the donor-site complications associated with the osteocutaneous radial forearm free flap (ORFFF) used for mandibular reconstruction, as well as to compare donor-site complications between the ORFFF and fasciocutaneous radial forearm free flap (FRFFF). Methods An Institution Review Board approved, retrospective review identified all ORFFF and FRFFF performed for head and neck reconstruction with a single otolaryngology surgeon at an academic medical center over a 3-year period. Patients requiring an ORFFF underwent harvest of half of the diaphyseal diameter of the radius with prophylactic plating performed by hand surgeons. Donor-site outcomes including infection, skin graft loss, tendon exposure, neuropathy, radius fracture, hardware complications, and need for additional donor-site surgery were compared. Results In this study, 25 patients underwent ORFFF harvest, and 52 underwent FRFFF harvest. There was one radius fracture occurring in association with a hardware infection requiring reoperation. No fractures or other major donor-site complications were seen in the FRFFF group. Similar rates of minor complications were noted with skin graft take less than 50% in 4% (n = 1) and 8% (n = 4) with ORFFF and FRFFF, respectively, and tendon exposure in 8% (n = 2) and 15% (n = 8) with ORFFF and FRFFF, respectively. No soft tissue infections or sensory neuropathies were seen. Mean follow-up was 14.2 months for the ORFFF group and 11.7 months for the FRFFF group. Conclusion The risk of fracture following ORFFF harvest with prophylactic plating is small. Other donor-site complication rates were similar with both flap techniques.

Osteocutaneous radial forearm free flap in nonmandible head and neck reconstruction

Head & Neck ◽  
2017 ◽  
Vol 39 (9) ◽  
pp. 1888-1893 ◽  
Author(s):  
Faisal I. Ahmad ◽  
Casey Means ◽  
Alex B. Labby ◽  
Scott H. Troob ◽  
Javier D. Gonzalez ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Radial Forearm Free Flap ◽  
Neck Reconstruction ◽  
Radial Forearm
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