Posterior radial collateral artery as the basis of the lateral forearm flap

The lateral forearm flap is being increasingly used for covering minor-to-moderate-sized defects for which soft and thin skin is required. Within the framework of an anatomic study carried out on 28 cadaveric arms, the authors investigated the principal artery that supplies blood to this flap namely, the posterior radial collateral artery (PRCA). They found that distal to the lateral epicondyle, the PRCA lies in a constant axial line lateral to the brachioradialis muscle. The average length of the artery distal to the epicondyle is 8 cm. Distal to the epicondyle side branches of the PRCA build an arterial plexus 6 cm (+/-3.5 cm) long and 5 cm (+/-1.1 cm) wide. The posterior cutaneous antebrachii nerve lies close to the artery. This permits the harvesting of a flap that is both innervated and has adequate vascular supply.