Donor-site morbidity following radial forearm free tissue transfer in head and neck surgery.
OBJECTIVE
To comprehensively evaluate long-term quantitative and qualitative donor-site morbidity following radial forearm free tissue harvest.


METHODS
A single-centre retrospective cohort study with internal controls was undertaken.


METHODS
Quantitative measurements of range of motion (ROM) of the forearm, wrist, and digits were performed. Grip and pinch strength and hand dexterity were also evaluated. Qualitative assessment was performed using the Michigan Hand Outcomes Questionnaire (MHQ), a validated quality of life instrument.


METHODS
Quantitative primary outcome measures were (1) wrist flexion and extension, (2 forearm pronation and supination, and (3) hand dexterity. The qualitative primary outcome measure was overall MHQ score.


RESULTS
The operated side demonstrated decreased hand dexterity (p = .008), with no change in wrist and forearm ROM. An increase in ROM of the little finger was found (p = .002). The MHQ demonstrated a perceived decrease in function (p = .031), an increase in pain (p = .045), and no difference in appearance (p = .486).


CONCLUSIONS
The radial forearm free flap results in measurable quantitative changes in hand function and limited changes in patient perception. Donor-site appearance does not seem to be an important factor.
Sardesai
Maya G
MG
Division of Head and Neck Oncology and Reconstructive Surgery, Department of Otolaryngology, London Health Sciences Centre, London, Ontario.
Fung
Kevin
K
Yoo
John H
JH
Bakker
Heidi
H
D005260:Female; D005500:Follow-Up Studies; D005542:Forearm; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D014019:Tissue Donors / Q000523:psychology / Q000706:statistics & numerical data*