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Osteocutaneous radial forearm flap for hand reconstruction
H Yajima1, S Tamai, T Yamauchi
1Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan.
The Journal of Hand Surgery
|June 5, 1999
Summary
The osteocutaneous radial forearm flap is a successful one-stage reconstruction for thumb loss and hand defects. This versatile flap provides both skin and bone, ensuring good outcomes with minimal complications.
Area of Science:
- Plastic Surgery
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Bone and soft tissue defects, including total thumb loss, pose significant reconstructive challenges.
- Traditional methods may require multiple stages or result in suboptimal functional and aesthetic outcomes.
Purpose of the Study:
- To evaluate the efficacy of the osteocutaneous radial forearm flap for one-stage reconstruction of thumb loss and hand defects.
- To assess flap survival, bone union, sensory recovery, and donor site morbidity.
Main Methods:
- A retrospective review of 5 patients undergoing osteocutaneous radial forearm flap reconstruction for thumb loss or hand defects.
- The flap incorporated radial bone segments (2-7 cm) and often included the lateral antebrachial cutaneous nerve for sensation.
- Simultaneous iliac bone grafting was performed in 4 cases to address donor site defects.
Main Results:
- All 5 flaps achieved complete survival.
- Radiographic bone union occurred within 2-3 months (mean 2.5 months).
- Two-point discrimination in sensory flaps ranged from 8-15 mm (mean 10.8 mm), with no radius fractures or vascular complications.
Conclusions:
- The osteocutaneous radial forearm flap is a reliable and effective option for one-stage reconstruction of thumb loss and hand defects.
- It offers a good combination of thin, textured skin and bone, with low donor site morbidity.
- This flap is particularly recommended when other options like free foot tissue transfer are not feasible or desired.