[Primary and secondary covering of defects of the hand using pedicled and free forearm flaps]

Our experiences in eight radial forearm flaps as free flaps or island flaps are shown. Indications for the use of these flaps in the hand are shown and advantages and disadvantages mentioned. Since 1980, when Mühlbauer and others brought the idea of this flap from China to Europe, its use as an island or as a free flap has been mentioned repeatedly. Generally the safety of this flap and the ease of harvesting are stressed. Other advantages are the long vascular pedicle and the large size of the vessels. These advantages are a temptation to use this flap for indications where it is not really suitable and where other methods are better. It has to be stressed that the donor site is not without problems from an esthetic and functional point of view. The removal of the radial artery, even when replaced by a venous graft may have some drawbacks.