Radial forearm osteocutaneous free flap in maxillofacial and oromandibular reconstructions.
OBJECTIVE
The radial forearm osteocutaneous free flap is an excellent reconstructive modality for oromandibular and maxillofacial reconstruction in certain well-defined circumstances. The initial concern over donor site morbidity and the ability of the bone to reconstruct mandibular defects have led to only a few published series.


METHODS
Retrospective study of the experience of two tertiary medical centers with radial forearm osteocutaneous free flap.


METHODS
Retrospectively, 52 patients were studied who underwent radial forearm osteocutaneous free flap reconstruction for cancer (49 cases) and trauma (3 cases). Bone length and skin paddle harvested, general morbidity (hematoma, wound infection, and dehiscence), recipient site morbidity (nonunion of neomandible, flap failure, and bone or plate exposure), and donor site morbidity (radius bone fracture, plate exposure, and skin graft failure) were reviewed.


RESULTS
The average skin paddle size was 55.1 cm (range, 15-112 cm). The average radius bone harvest length was 6.3 cm (range, 2.5-11 cm). Donor site complications included tendon exposure (3 cases), radius bone fracture (1 case), and exposure of the plate (0). Recipient site complications included nonunion of the mandible (4), exposed mandible (1), exposed mandibular plates (2), exposed maxillary plates or bone (0), venous compromise (1), and flap failure (1). Two patients had perioperative deaths.


CONCLUSIONS
Radial forearm osteocutaneous free flap is a valuable and viable option for oromandibular and maxillofacial reconstruction.
Kim
J H
JH
Departments of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97233, USA.
Rosenthal
E L
EL
Ellis
T
T
Wax
M K
MK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005151:Facial Injuries / Q000601:surgery; D005260:Female; D005542:Forearm; D006085:Graft Survival; D006801:Humans; D007573:Jaw Neoplasms / Q000601:surgery; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery; D008441:Maxillary Neoplasms / Q000601:surgery; D008446:Maxillofacial Injuries / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D019647:Oral Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013524:Surgical Flaps