Study of the tendinous vascularization for the compound radial forearm flap plus flexor carpi radialis tendon.
OBJECTIVE
The aim of this study was to explore the tendinous vascularization of flexor carpi radialis (FCR) and investigate the anatomical basis for harvesting the compound radial forearm flap (free or pedicled) with the vascularized tendon for the reconstruction of cutaneotendinous defects.


METHODS
The area of the radial forearm flap was studied in seventeen forearms of fresh cadavers injected with red latex. A lozenge-shaped flap about 9 cm long and 4 cm wide was raised along the axis of the radial artery. Dissection of the flap was carried out subfascially. We searched perforators going into the flap and the nutritive branches for the tendon sheath of FCR were dissected up to their origin from the radial artery. Their distance from the scaphoid tubercle was recorded.


RESULTS
We found nutritive branches for all the length of the tendon. The mean number of perforators going into the tendon sheath was 9.5 (range 8-12). Constant sizeable branches larger than 0.2 mm were identified from the scaphoid tubercle to the myotendinous junction; their distance from the scaphoid tubercle ranged between 0.5 and 12.5 cm. We found an average 0.8 perforators/cm of tendon (range 0.7-1). The donor sites were always closed primarily.


CONCLUSIONS
Nutrient branches of the radial artery for the tendon of FCR were constantly found. Our anatomical findings confirm the possibility of raising a compound radial forearm flap including a sure vascularized tendon of FCR. Its clinical application provides a quick and straightforward single-stage option for the reconstruction of complex cutaneotendinous defects.
Plastic Surgery and Reconstructive Microsurgery Unit, Department of Surgery and Translational Medicine, University of Florence, Largo Piero Palagi, 1, Florence, Italy. andrea.raspanti@live.it.
Andrea
A
Raspanti
Plastic Surgery and Reconstructive Microsurgery Unit, Department of Surgery and Translational Medicine, University of Florence, Largo Piero Palagi, 1, Florence, Italy.
Luca
L
Delcroix
Plastic Surgery and Reconstructive Microsurgery Unit, Department of Surgery and Translational Medicine, University of Florence, Largo Piero Palagi, 1, Florence, Italy.
Serena
S
Ghezzi
Plastic Surgery and Reconstructive Microsurgery Unit, Department of Surgery and Translational Medicine, University of Florence, Largo Piero Palagi, 1, Florence, Italy.
Marco
M
Innocenti
D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D008297:Male; D013524:Surgical Flaps / Q000098:blood supply*; D013710:Tendons / Q000098:blood supply*
Composite Chinese flap; Compound radial forearm flap; Flexor carpi radialis tendon; Vascularized tendon graft