OSTEOCUTANEOUS RADIAL FOREARM FREE FLAP FOR MAXILLA RECONSTRUCTION: SURGICAL TECHNIQUE

Abstract

Osteocutaneous Radial Forearm free flap (OCRFF) is a composite flap comprised of a segment of the radial bone with the fasciocutaneous component and is based on Radial artery with Vena comitantes and cephalic vein as pedicle. It is used in midfacial reconstruction especially in the maxillary region involving bony defect. The advantage of this flap is that it is a thin, pliable flap with rich vascularity which provides a soft tissue covering along with a vascularized bone graft. In the recent studies, the flap survival rate is reported to be as high as 96-100% and the donor site complications are relatively low. The key to the success of this flap lies in meticulous pre-operative assessment including Allen’s test, proper imaging techniques which includes, USG doppler study of the donor site. Correct technique of flap harvest, radial osteotomy and plating (prophylactic fixation) ensures minimal chances of post-operative complications and flap failure. This article focuses on the pre-operative assessment, relevant anatomy and basic steps of flap harvest technique of OCRFF and aims to encourage the microvascular enthusiasts.