Faculty Collaboration Database

The lateral arm fascial free flap: its anatomy and use in reconstruction. Plast Reconstr Surg 1990 Dec;86(6):1138-45; discussion 1146-7

Date

12/01/1990

Pubmed ID

2243857

DOI

10.1097/00006534-199012000-00016

Scopus ID

2-s2.0-0025633256 (requires institutional sign-in at Scopus site)   106 Citations

Abstract

Free fascial transfer has been used for reconstruction of gliding surfaces of the upper and lower extremities or when thin, pliable coverage is required (hand, heel, nose, and ear). In our experience with the lateral arm fasciocutaneous flap, we have found that the fascia alone is an excellent source of tissue for free flap transfer. A thorough investigation of the microscopic, gross, and radiographic anatomy of the lateral arm fascia was undertaken by the study of 25 fresh cadavers. Vascular pathways were mapped, their locations were analyzed, and then they were correlated with the elevation, design, and transfer of the flap. The lateral arm has a large fascial component located anterior and posterior to the lateral intermuscular septum, which itself lies between the triceps and the brachialis and brachioradialis muscles. It is perfused by the posterior radial collateral artery (PRCA), one of the terminal branches of the profunda brachii. This vessel (PRCA) provides at least four fascial branches from 1 to 15 cm proximal to the lateral epicondyle, the largest of which is located an average of 9.7 cm superior to the lateral epicondyle. Fascia up to 12 x 9 cm may be used with good axial perfusion. The histologic cross sections demonstrate the complex anatomy of the fascia itself, as well as its relation to the nutrient vessels. We have applied the lateral arm fascial flap in five cases of upper extremity reconstruction. We have also found this flap valuable in preservation of underlying anatomic detail for total reconstruction of the ear and nose when local tissue and more conventional flaps were not available.

Author List

Yousif NJ, Warren R, Matloub HS, Sanger JR

Authors

Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of Wisconsin
James R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Arm
Ear
Facial Injuries
Fascia
Female
Forearm Injuries
Hand Injuries
Humans
Male
Middle Aged
Surgical Flaps
Wounds and Injuries