title: Long-term vascular, motor, and sensory donor site outcomes after ulnar forearm flap harvest.
abstract: Use of the ulnar forearm flap (UFF) is limited by concerns for ulnar nerve injury and impaired perfusion in the donor extremity. Twenty UFFs were performed over a 6-year period. All patients underwent postoperative bilateral upper extremity arterial duplex studies. A subset of postoperative patients (n = 10) also had bilateral upper extremity sensory and motor evaluations, and functional evaluation via the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH). Motor function was tested by digital and key grip dynamometry. Ulnar nerve sensation was tested by evaluation of one- and two-point perceived pressure thresholds and two-point discrimination using the Pressure-Specified Sensory Device (Sensory Management Services, LLC, Baltimore, MD). All UFFs were viable postoperatively. Mean follow-up was 28.8 months for vascular studies and 45.3 months for motor, sensory, and QuickDASH evaluations. Although mid and distal radial artery flow velocities were significantly higher in donor versus control extremities evaluated at less than 1 year postoperatively, there was no significant difference in extremities evaluated at later time points. Digital pressures, grip strength, key pinch strength, and ulnar sensation were equivalent between donor and control extremities. The mean QuickDASH score was 17.4 ± 23.8. The UFF can be harvested reliably and long-term follow-up shows no evidence of impaired vascular, motor, or sensory function in the donor extremity.
authors.affiliation: Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Emile N
authors.initials: EN
authors.lastname: Brown
authors.affiliation: Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Arif
authors.initials: A
authors.lastname: Chaudhry
authors.affiliation: Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Suhail K
authors.initials: SK
authors.lastname: Mithani
authors.affiliation: Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Rachel O
authors.initials: RO
authors.lastname: Bluebond-Langner
authors.affiliation: Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Feiner
authors.affiliation: Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Shaffer
authors.affiliation: Vascular Lab, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Diana
authors.initials: D
authors.lastname: Call
authors.affiliation: Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Eduardo D
authors.initials: ED
authors.lastname: Rodriguez
mesh_terms: D001783:Blood Flow Velocity; D004185:Disability Evaluation; D005260:Female; D005542:Forearm / Q000098:blood supply* / Q000294:innervation / Q000601:surgery; D058752:Free Tissue Flaps / Q000098:blood supply; D006085:Graft Survival; D018737:Hand Strength; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D017534:Radial Artery / Q000503:physiopathology; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012684:Sensory Thresholds; D011795:Surveys and Questionnaires; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D060053:Transplant Donor Site / Q000503:physiopathology*; D014459:Ulnar Nerve / Q000503:physiopathology