Upper extremity morbidity after radial forearm flap harvest: a prospective study

Area of Science:

• Reconstructive surgery
• Orthopedics
• Oncology

Background:

• Head and neck cancer often requires complex surgical resection.
• Reconstructive procedures, such as the radial forearm free (RFF) flap, are crucial for restoring function.
• The impact of RFF flap harvest on upper extremity function requires detailed investigation.

Purpose of the Study:

• To evaluate the effect of radial forearm free (RFF) flap harvest on patient-reported upper extremity disability.
• To compare functional outcomes between patients undergoing RFF flap reconstruction and those receiving alternative reconstruction methods.

Main Methods:

• Patients undergoing RFF flap reconstruction for head and neck cancer were identified.
• A control group of patients undergoing non-RFF reconstruction was matched for comparison.
• The Disability of the Arm, Shoulder, and Hand (DASH) questionnaire was administered preoperatively and at least 1 year postoperatively.

Main Results:

• Patients who underwent RFF flap reconstruction had significantly higher postoperative DASH scores, indicating greater upper extremity disability.
• The mean postoperative DASH score for the RFF group was 6.93 ± 5.54, compared to 2.95 ± 4.42 for the non-RFF group.
• Preoperative DASH score, flap size, patient age, and tumor stage were significantly correlated with postoperative functional outcomes.

Conclusions:

• Radial forearm free (RFF) flap reconstruction leads to a significant negative impact on upper extremity function.
• These findings are independent of the effects of neck dissection procedures.
• The study highlights the functional trade-offs associated with RFF flap use in head and neck cancer reconstruction.