title: The transverse radial artery forearm flap.
abstract: BACKGROUND
  In an attempt to improve the versatility of the radial forearm flap, a new design was developed: the transverse radial artery forearm flap.
  
  
  METHODS
  The transverse radial artery forearm flap is designed elliptically in the distal palmar forearm with the long axis oriented transversely parallel to the wrist. The donor defect is closed by a V-shaped flap, which is elevated as a fasciocutaneous flap based on the ulnar artery by V-Y advancement. This second flap allows defect coverage without the need for a skin graft. From March of 1994 to February of 2005, the authors treated 39 patients with this flap. Free flaps were used in 36 patients and three patients were operated on with reverse pedicled flaps.
  
  
  RESULTS
  Twenty-five patients had head and neck defects, 11 patients had defects of the distal foot or great toe, and three patients had hand defects. In 13 cases, an osteocutaneous flap was elevated, and three flaps were transferred as sensate flaps. Maximum flap dimensions were 10 x 6 cm. The longest vascular pedicle in this series was 20 cm. All flaps survived. Except for two cases of delayed healing, no complications occurred at the donor site.
  
  
  CONCLUSIONS
  The transverse radial artery forearm flap is more versatile than the conventional radial flap, with the additional advantage of a long vascular pedicle. Its design allows for harvest of a piece of radial bone, which is pedicled on a completely different portion of the radial artery than the skin paddle. Thus, the setting of the bony portion can be chosen liberally. Donor-site morbidity is reduced, and the result is aesthetically pleasing.
authors.affiliation: Seoul, Korea From the Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine.
authors.forename: Hee Chang
authors.initials: HC
authors.lastname: Ahn
authors.forename: Matthew Seung Suk
authors.initials: MSS
authors.lastname: Choi
authors.forename: Won Joong
authors.initials: WJ
authors.lastname: Hwang
authors.forename: Kun Yong
authors.initials: KY
authors.lastname: Sung
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D019651:Plastic Surgery Procedures; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D014947:Wounds and Injuries / Q000601:surgery*