Dealing with aberrant vessels in radial forearm flaps – Report of a case and review of literature

Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation

“…Reconstruction with free LD flaps and R-plates has the major advantage of simultaneous reconstruction of muscular, bony and skin defects with a single free flap (Danino et al, 2003;Bhatt et al, 2009;Achal et al, 2011). In our experience the LD free flap and Rplate reconstruction is very reliable in performing composite reconstructions of large maxillofacial defects showing a success rate of 99.1%.…”

“…These flaps can be soft tissue only (forearm, rectus abdominis, and anterolateral thigh) or have a bone element (fibula, deep circumflex iliac artery, and scapula). Each flap type has its advantages and disadvantages (Bhatt et al, 2009;Achal et al, 2011;Girod et al, 2011). However, large and complex tissue defects in the maxillofacial region pose challenges for reconstructive surgery especially when free tissue transfer is being considered.…”

Anatomical variations in forearm vascular anatomy

“…Its accidental division during the raising of the radial forearm flap can seriously jeopardize hand circulation. Anomalies of the ulnar artery have been previously reported (Fatah et al, 1985;Thoma and Young, 1992;Devansh, 1996). In cadaver dissections the incidence is reported to be 9.3%.…”

“…In cadaver dissections the incidence is reported to be 9.3%. Free flaps raised on such a vessel have also been reported (Devansh, 1996;Sieg et al, 2006). This variation is probably encountered in clinical practice more commonly, but it is not recognized.…”

“…I recently reported a case of aberrant forearm vascular anatomy with a brief review of the literature on anomalies and variations of the radial artery (Bhatt et al, 2009). A year further into my training, I have encountered a further case of anatomical aberrance, this time of the ulnar vessels.…”