title: Outcomes of the osteocutaneous radial forearm free flap for mandibular reconstruction.
abstract: OBJECTIVE
  Limited donor and recipient site complications support the osteocutaneous radial forearm free flap (OCRFFF) for mandibular reconstruction as a useful option for single-stage mandibular reconstruction.
  
  
  OBJECTIVE
  To examine and report long-term outcomes and complications at the donor and recipient sites for patients undergoing the OCRFFF for mandibular reconstruction.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Academic, tertiary care medical center.
  
  
  METHODS
  The study population comprised 167 consecutive patients who underwent single-staged mandibular reconstruction with an OCRFFF.
  
  
  METHODS
  Rates of complications at the donor and recipient sites.
  
  
  RESULTS
  The mean patient age was 61 years (range, 20-93 years). Men compromised 68% of the population. Follow-up interval ranged from 2 to 99 months (mean, 25.9 months). The median length of bone harvested was 7 cm (range, 2.5-12.0 cm). Prophylactic plating was completed for each of the radii at the time of harvest. Donor site complications included radial fracture (1 patient [0.5%]), tendon exposure (47 patients [28%]), and donor hand weakness or numbness (13 patients [9%]). Recipient site complications included mandible hardware exposure (29 patients [17%]), mandible nonunion or malunion (4 patients [2%]), and mandible bone or hardware fracture (4 patients [2%]). Using regression analysis, we found that patients were 1.3 times more likely to have plate exposure for every increase of 1 cm of bone harvest length; this was statistically significant (P = .04).
  
  
  CONCLUSIONS
  This is the largest single study reporting outcomes and complications for patients undergoing OCRFFF for mandibular reconstruction. Prophylactic plating of the donor radius has nearly eliminated the risk of pathologic radial bone fractures. Limited long-term donor and recipient site complications support the use of this flap for single-stage mandibular reconstruction.
authors: Departments of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USA. jarganbright@kumc.edu
authors: Jill M
authors: JM
authors: Arganbright
authors: Terance T
authors: TT
authors: Tsue
authors: Douglas A
authors: DA
authors: Girod
authors: Oleg N
authors: ON
authors: Militsakh
authors: Kevin J
authors: KJ
authors: Sykes
authors: Jeff
authors: J
authors: Markey
authors: Yelizaveta
authors: Y
authors: Shnayder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005542:Forearm; D006085:Graft Survival; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008297:Male; D008334:Mandible / Q000601:surgery*; D008338:Mandibular Injuries / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D011183:Postoperative Complications; D011884:Radius / Q000637:transplantation*; D011885:Radius Fractures / Q000209:etiology; D012044:Regression Analysis; D012189:Retrospective Studies; D013524:Surgical Flaps; D060053:Transplant Donor Site; D055815:Young Adult