Osteocutaneous radial forearm free flap: Its use without significant donor site morbidity

While the fasciocutaneous radial forearm free flap has gained increasing popularity, the osteocutaneous radial forearm free flap has been condemned because of a high rate of pathologic donor radius fracture. On the basis of studies that demonstrated increased strength in ostectomized radii after dyn...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2000-12, Vol.123 (6), p.711-717
Main Authors: Werle, Andreas H, Tsue, Terance T, Toby, E.Bruce, Girod, Douglas A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Bone Plates
Bone Remodeling
Bone Screws
Female
Forearm - diagnostic imaging
Forearm - physiology
Forearm - surgery
Fracture Healing
Hand Strength
Head and Neck Neoplasms - surgery
Humans
Male
Middle Aged
Morbidity
Radiography
Radius - diagnostic imaging
Radius - physiology
Radius - transplantation
Range of Motion, Articular
Retrospective Studies
Skin Transplantation - adverse effects
Skin Transplantation - methods
Surgical Flaps - adverse effects
Tissue and Organ Harvesting - adverse effects
Tissue and Organ Harvesting - methods
Treatment Outcome
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Summary:While the fasciocutaneous radial forearm free flap has gained increasing popularity, the osteocutaneous radial forearm free flap has been condemned because of a high rate of pathologic donor radius fracture. On the basis of studies that demonstrated increased strength in ostectomized radii after dynamic compression plating, we believed that internal fixation at the time of graft harvest would significantly reduce the incidence of donor radius fracture. This is a retrospective review of the first 54 patients undergoing osteocutaneous radial forearm free flap reconstruction of the head and neck at our institution; 52 underwent prophylactic plating of their donor radii. No clinically significant donor radius fractures have occurred in plated patients. Five asymptomatic fractures were discovered on routine radiographs and required no treatment. Objective evaluation of forearm range of motion and strength after graft harvest demonstrated excellent function compared with unoperated arms. Serial radiographs have shown remodeling and reconstitution of donor radii without localized osteopenia. (Otolaryngol Head Neck Surg 2000;123:711-7.)
ISSN:0194-5998
1097-6817
DOI:10.1067/mhn.2000.110865