RADIAL FOREARM FLAP DONOR-SITE COMPLICATIONS AND MORBIDITY - A PROSPECTIVE-STUDY

One-hundred patients undergoing radial forearm nap reconstruction in t he head and neck over a 2-year period were followed prospectively to a ssess complications and morbidity associated with the radial flap dono r site. Eighty-six patients were available for follow-up at 3 months a nd 74 at 1 year (49 fasciocutaneous, 25 composite). Partial loss of th e donor-site skin graft occurred in 14 patients (16 percent), with exp osure of tendons in 11 patients (13 percent). Delay in healing of the split-thickness skin graft at the donor site occurred in 19 patients ( 22 percent). Fracture of the radius occurred in 6 of 35 patients with composite flaps (17 percent). Superficial radial nerve sensation was r educed in 24 patients (32 percent) at 1 year. Ten patients (14 percent ) reported cold intolerance, and 21 patients (28 percent) complained o f poor aesthetic result. Function of the donor arm was restricted in 8 patients (16 percent) in the fasciocutaneous group, in 7 patients (36 percent) in the composite group without fracture, and in all patients who had a fracture of the radius following harvesting of composite fl aps. Detailed measurements of forearm circumference, grip strength, pi nch strength, and wrist movements showed greater reduction in these pa rameters in patients reporting restricted function compared with those reporting normal function. It is concluded that there is a low incide nce of long-term morbidity associated with fasciocutaneous flaps and a higher incidence with composite flaps. Fracture of the radius results in reduced function in all cases.