title: Treatment of segmental bone and soft-tissue defects of the forearm with the free osteocutaneous lateral arm flap.
abstract: BACKGROUND
  Complex defects of the forearm often require microvascular reconstruction with osteocutaneous free flaps to salvage the limb. In this review, we report our experience with the use of the free osteocutaneous lateral arm flap to reconstruct such defects in four patients.
  
  
  METHODS
  Three male patients with osseous defects of the ulna and one defect of the radius with associated soft-tissue defects were treated with a free osteocutaneous lateral arm flap between 2004 and 2007. The indications for the procedure included posttraumatic osteitis (3) and bone with soft-tissue defects after trauma (1). We evaluated the patients with respect to postoperative results by evaluating the range of motion, pain, strength, and score on the disabilities of the arm, shoulder, and hand questionnaire. Donor-site morbidity was also documented.
  
  
  RESULTS
  The average length of segmental bone defects was 5.75 cm. The average dimension of the skin paddle was 99.5 cm. The average duration of follow-up was 43.3 months. All bone flaps healed without nonunion; the fasciocutaneous flaps healed without complications. No problems related to microanastomoses were found. Functional results were very satisfactory; disabilities of the arm, shoulder, and hand questionnaire scores showed a median of 5.8 (0-10.8). All patients had returned to their preinjury occupations.
  
  
  CONCLUSIONS
  This analysis demonstrates that the free osteocutaneous lateral arm flap is an effective treatment for combined segmental osseous and soft-tissue defects of the forearm that are caused by osteitis and trauma.
authors: AUVA Traumacenter, Department of Plastic and Reconstructive Surgery, Hospital Rudolfsstiftung, Vienna, Austria. christian.windhofer@gmail.com
authors: Christian
authors: C
authors: Windhofer
authors: Wolfgang
authors: W
authors: Michlits
authors: Alois
authors: A
authors: Karlbauer
authors: Christoph
authors: C
authors: Papp