DONOR SITE MORBIDITY OF RADIAL FOREARM FLAPS - A CLINICAL AND ULTRASONOGRAPHIC EVALUATION

Harvesting of a forearm flap based on the radial artery has been thoug ht to cause functional or circulatory problems in the donor hand. Eigh teen patients were examined three to 24 months after a radial forearm flap had been raised. The function of both hands was studied for grip strength, mobility of the wrist and elbow joints, and sensitivity of t he area served by the superficial radial nerve. The patients were inte rviewed and the cosmetic result was evaluated. Duplex ultrasonography and colour Doppler ultrasonography of both ulnar arteries were done, a nd the brachial arteries were measured as controls. Angle-corrected pe ak flow velocity (cm/s) in the ulnar artery of the donor forearm was s ignificantly increased at the level of the wrist compared with the con trol forearm (100.9 compared with 73.1 cm/s, p = 0.017), as was the ul nar:brachial peak flow velocity ratio (1.18 compared with 0.76, p = 0. 001). The grip strength of the donor hand was weaker by 11.9% (86.5 co mpared with 72.2 Kp), 10 (56%) had areas of sensory loss over the radi al nerve distribution, and seven of the 18 patients complained of cold intolerance. Four patients considered the donor site result so bad th at they would not have chosen the operation had they known what the re sult would look like. The radial forearm flap donor site is not withou t problems, and the patients must be carefully selected and properly i nformed preoperatively.