THE RADIAL FOREARM FLAP IN RECONSTRUCTION OF UPPER LIMB INJURIES: A CASE SERIES.
*Burns and Plastic Surgery Unit, Surgery Department, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.
**Plastic Surgery Department, National Orthopaedic Hospital, Enugu, Enugu State, Nigeria.
*** Burns and Plastic Surgery Unit, Surgery Department, University of Nigeria
Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria.
BACKGROUND: The Radial Forearm Flap is a fasciocutaneous flap which has established its role in soft tissue reconstruction in the head and neck region as a free flap. Its value as a useful flap in soft tissue reconstruction in upper limb injuries has also been recognized. However there has been a dearth of report in our sub region on the use of this flap.
OBJECTIVE: To report the use of Radial Forearm Flap in the reconstruction of traumatic defects in the elbow and hand in our centre.METHODS: Four cases in which pedicled island Radial Forearm Flaps were successfully used to reconstruct difficult defects in the elbow and hand following injuries were reviewed.
RESULTS: Four pedicled island Radial Forearm Flaps were used to reconstruct soft tissue defects in four sites in the upper limb following trauma. One of the flaps was proximally based for coverage of lateral elbow defect while the others were used to cover defects of dorsum of wrist, mid palmar amputation and first web space. The first web space defect required a fascial flap and split skin graft cover. All the procedures were single staged and the flaps survived providing dependable soft tissue cover.
CONCLUSION: The pedicled radial forearm flap was effective in providing skin cover of difficult soft tissue defects in the elbow, wrist and hand of our patients. It is a single stage procedure which allowed for early mobilization of the limb. Design and elevation of the flap was not as technically demanding as microsurgical tissue transfer which is still in its infancy in most developing countries like Nigeria.
Key words: Elbow defect, Hand defect, Pedicled radial forearm island flap.