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

• 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
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1067/mhn.2000.110865

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.)