The lateral upper arm flap: anatomy and clinical applications

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Anatomy

Background:

• Identifying dependable donor sites is crucial for successful free flap reconstruction.
• The posterolateral distal upper arm presents a potential, yet underexplored, donor site for tissue transfer.

Observation:

• The posterior radial collateral artery, a branch of the profunda brachii, vascularizes the flap area.
• A direct cutaneous nerve supplies the flap, preserving sensory function.
• The flap can be designed with or without underlying tendon, bone, or fascia.

Findings:

• Thirty-two cadaver dissections and 23 clinical cases confirm the reliability and moderate size of this donor site.
• The vascular and neural supply are consistently identified, facilitating flap elevation.
• Versatility in harvesting allows for tailored tissue transfer based on recipient site needs.

Implications:

• This study establishes a dependable free flap donor site in the distal upper arm for reconstructive procedures.
• The findings offer surgeons a valuable alternative for tissue reconstruction, potentially reducing donor site morbidity.
• Further research can explore long-term outcomes and expand applications of this anatomical region in plastic surgery.