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

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.

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

scholarly journals A Vascular Variation in Radial Forearm Free Flap Harvesting: Distal Branching of the Radial Artery—A Case Report

2021 ◽  
Vol 6 ◽  
pp. 247275122110414
Author(s):  
Jonas Wüster ◽  
Benedicta Beck-Broichsitter ◽  
Steffen Koerdt ◽  
Max Heiland ◽  
Maximilian Goedecke
Keyword(s):  
Case Report ◽  
Postoperative Complications ◽  
Radial Artery ◽  
Free Flap ◽  
Radial Forearm Free Flap ◽  
Skin Paddle ◽  
Vascular Variations ◽  
Photo Documentation ◽  
Radial Forearm ◽  
Flap Perfusion

Study Design: Case report. Objective: By reporting such a rare vascular variation of the radial artery, we aim to make other surgeons aware of comparable vascular variations in radial forearm free flap harvesting. Methods: In this case report, we present an 84-year-old male patient, with a rare distal branching of the radial artery into the deep palmar branch, approximately 7 cm from the wrist. In order to visualize the vascular variation, intraoperative photo documentation took place. Results: The radial free flap harvesting was successful and no postoperative complications were noted. Conclusions: Distal branching of the radial artery into the deep palmar branch may occur in radial forearm free flap harvesting. Since no restrictions in flap perfusion and/or hand perfusion were observed in our case, we recommend radial forearm free flap raising in the traditional way. No changes concerning the design and the positioning of the skin paddle need to be made.

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