The lateral arm free flap for head and neck reconstruction

The lateral arm free flap has proved to be both a versatile and successful method of reconstruction. Since its introduction a decade ago, however, its application in head and neck reconstruction has been fairly limited. Dissection of the flap, based on the posterior radial collateral branch of the profunda brachii artery, is relatively simple and provides a thin, dependable flap that has the potential to be used as a osteocutaneous flap or as a fasciocutaneous flap alone. The flap contains a sensory nerve that is readily anastomosed and donor site morbidity is limited. Although the pedicle is short, several modifications exist that allow its extension. This flap has been used successfully to reconstruct various defects in the head and neck. Pertinent anatomy, indications, and guidelines for clinical application will be discussed.