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Related Experiment Video

Updated: Jun 16, 2026

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
10:36

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach

Published on: May 23, 2025

Contralateral pedicled lateral arm flap for hand reconstruction.

Siew-Weng Ng1, Lam-Chuan Teoh, Yi-Liang Jonathan Lee

  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore. sweng8@gmail.com

Annals of Plastic Surgery
|January 26, 2010
PubMed
Summary

The contralateral pedicled lateral arm flap offers a reliable solution for reconstructing large hand defects when pedicled flaps are necessary. This technique ensures flap survival and functional recovery with minimal patient morbidity.

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Area of Science:

  • Plastic Surgery
  • Hand Surgery
  • Reconstructive Surgery

Background:

  • Large hand defects often necessitate flap resurfacing for durable coverage and function preservation.
  • Pedicled flaps are crucial when recipient vessels are compromised or reserved for other procedures.
  • The contralateral pedicled lateral arm flap presents a novel alternative for such challenging reconstructions.

Purpose of the Study:

  • To evaluate the efficacy and reliability of the contralateral pedicled lateral arm flap for hand defect reconstruction.
  • To assess functional outcomes and morbidity associated with this reconstructive technique.

Main Methods:

  • A retrospective review of 22 patients (aged 6-70) undergoing contralateral pedicled lateral arm flap reconstruction for hand defects (trauma, infection, burn, free flap complication) between 1988 and 2006.

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  • Flap design included forearm extension, based on the posterior radial collateral artery.
  • Patients underwent intensive mobilization, with flap division at 3 weeks post-ischemic preconditioning.

    • Main Results:

    • All 22 flaps survived without wound infection.
    • Flap sizes ranged from 18 cm² to 127.5 cm², with 18 fasciocutaneous and 4 osteofasciocutaneous reconstructions.
    • Patients achieved independent activities of daily living by postoperative day 3, with no significant shoulder or elbow joint stiffness.

    Conclusions:

    • The contralateral pedicled lateral arm flap is a dependable option for hand defect coverage when pedicled flaps are indicated.
    • This method provides durable reconstruction with minimal donor site morbidity and good functional outcomes.