DONOR SITE DEFICIT OF THE OSTEOCUTANEOUS RADIAL FOREARM FLAP

A functional evaluation was made of osteocutaneous radial forearm flap donor upper extremities at a mean 19.4 months postoperatively. Donor deficits were evaluated as follows: (I) skin: subjective appearance an d durability; (2) skeleton: range of motion of adjacent joints; (3) ve ssels: cold intolerance, digital temperature, digital-brachial index; (4) muscle: key pinch; (5) nerve: two-point discrimination of dorsal f irst web space. Ten consecutive patients with a mean donor site area o f 51.5 cm(2) and mean length of harvested radius of 10.9 cm were studi ed. Incomplete skin graft take at the donor site (7 of 10 patients) an d appearance of fair or poor (6 of 10 patients) were frequent cutaneou s complications. Wrist range of motion was decreased with pronation (9 0%), flexion (90%), and extension (89%). Mean digital temperature, com paring extremities that did (operated) and did not (nonoperated) under go surgery, or comparing the radial artery-supplied fingers to the uln ar artery-supplied fingers within the same operated hand showed no eff ect from the lost radial artery. Mean digital-brachial index was 1.24 for the nonoperated and 1.15 for the operated extremity. Key pinch on the operated side was a mean of 74% of the nonoperated side. Although raising the flap creates multiple tissue deficits, each with the poten tial to alter upper extremity function, detailed functional evaluation failed to demonstrate significant alteration in upper extremity funct ion after flap harvest.