Immediate bone grafting and plating of the radial osteocutaneous free flap donor site. Academic Article uri icon

Overview

MeSH

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reconstructive Surgical Procedures
  • Retrospective Studies
  • Time Factors

MeSH Major

  • Bone Plates
  • Free Tissue Flaps
  • Head and Neck Neoplasms
  • Ilium
  • Radius
  • Skin Transplantation
  • Transplant Donor Site

abstract

  • The primary shortcoming of the osteocutaneous radial forearm flap (ORFF) in head and neck reconstruction is the high incidence of fracture at the donor site. Although several prophylactic measures are reported, combined plating with iliac crest bone graft (ICBG) of the donor site has not been previously described. Outcomes and rationale for this method of radius reconstruction are described. Retrospective review of a prospectively maintained database identified 23 consecutive patients who underwent head and neck reconstruction using an ORFF. Flap features, method of donor-site reconstruction, and complications were evaluated. The initial 7 patients from the series had no intervention at the radius donor site. The next 7 patients had ICBG only, whereas the final 9 patients had both plating and ICBG placed at the donor site. The mean cross-sectional diameter and length of radius bone harvested was 30% by 7 cm, 33% by 8 cm, and 53% by 9 cm for the 3 groups, respectively. Fracture rates for the 3 groups were 29%, 14%, and 0%. There were no iliac crest donor-site complications. Plating combined with ICBG is a safe and effective method for radius donor-site reconstruction. This technique maximizes both early and late strength of the radius while allowing for harvest of greater segments of bone. Decreased donor-site morbidity combined with more bone available for use in oromandibular reconstruction may tip the risk-benefit scale in favor of more widespread ORFF use.

publication date

  • September 2014

has subject area

  • Adolescent
  • Adult
  • Aged
  • Bone Plates
  • Female
  • Free Tissue Flaps
  • Head and Neck Neoplasms
  • Humans
  • Ilium
  • Male
  • Middle Aged
  • Radius
  • Reconstructive Surgical Procedures
  • Retrospective Studies
  • Skin Transplantation
  • Time Factors
  • Transplant Donor Site

Research

keywords

  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1097/SAP.0b013e31827a2fe4

PubMed ID

  • 24051470

Additional Document Info

start page

  • 315

end page

  • 320

volume

  • 73

number

  • 3