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Radial forearm flaps for reconstruction in hand surgery
Hiroshi Yajima1, Yasunori Kobata, Kenji Kawamura
1Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan.
Summary
Distally-based island radial forearm flaps demonstrate high survival rates for hand reconstruction. This study highlights their effectiveness in restoring function and sensation across various hand and thumb defects.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Radial forearm flaps are versatile for soft tissue reconstruction.
- Island flaps offer advantages in specific anatomical locations.
- Assessing outcomes of distally-based flaps is crucial for surgical planning.
Purpose of the Study:
- To evaluate the efficacy and outcomes of distally-based island radial forearm flaps.
- To analyze flap survival, donor-site morbidity, and functional results.
- To assess specific flap types (sensory, osteocutaneous, tendocutaneous) in hand reconstruction.
Main Methods:
- Retrospective analysis of 37 patients undergoing reconstruction with distally-based island radial forearm flaps.
- Categorization of reconstructed sites: dorsum of hand, thumb, fingers, first web, palm.
- Classification of flap types: sensory, osteocutaneous, tendocutaneous.
Main Results:
- All 37 flaps survived with no functional disturbances.
- Five donor-site complications occurred, with three patients experiencing cold intolerance.
- Osteocutaneous flaps achieved bony union in a mean of 2.6 months; tendocutaneous flaps required tenolysis in two cases with seven satisfactory outcomes.
- Sensory flaps achieved a mean moving 2-point discrimination of 13 mm.
Conclusions:
- Distally-based island radial forearm flaps are a reliable option for various hand reconstructions.
- The procedure offers good functional and sensory recovery with manageable donor-site morbidity.
- Specific flap modifications (osteocutaneous, tendocutaneous) show promising results for complex reconstructions.