Arch Hand Microsurg.  2022 Sep;27(3):270-273. 10.12790/ahm.22.0017.

Alteration of a radial forearm flap to adjust to the superficial radial artery: a case report

• Jwa SJ
• Choi JH
• Park S
• Suh YC

• KMID: 2532745
• DOI: http://doi.org/10.12790/ahm.22.0017

Abstract

Aberrant branches of the radial artery at the level of the forearm have rarely been reported. Preoperative workups to identify aberrant branches of this type have also seldom been performed. However, surgeons elevating a radial artery-based flap should consider the possibility of aberrant arterial branching. Otherwise, the circulation of both the flap and hand may be endangered. We present a case of an anomalous radial artery branch that resulted in an intraoperative alteration of the flap design. A novel technique was used to preserve the circulation of the entire flap, and the patient recovered with adequate healing of the flap and donor areas. No hand function deficits or subjective complaints were noted. In conclusion, surgeons should be aware of the superficial radial artery or other aberrant branches of the radial artery that may be located in various locations during radial artery-related flap elevation.

Keyword

Radial artery; Forearm; Free tissue flaps; Microsurgery

Figure

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  Fig. 1. The encountered aberrant artery. An aberrant artery (red arrow) was identified. It was located on the radial side of the deep radial artery, superficial to the brachioradialis muscle.

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  Fig. 2. Elevated flap. The flap was extended more proximally than the initial design (vertical blue marker lines) while replacing the distal end of the flap from the deep branch of the radial artery to the superficial radial artery.

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  Fig. 3. The flap containing both deep and superficial branches of the radial artery. The superficial radial artery (black arrow) branched from the deep branch of the radial artery (black asterisk) 6 cm proximal to the wrist crease at the point indicated by the forceps. Both the deep and superficial branches were included in the flap, whereas the cephalic vein (red asterisk) was not.

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  Fig. 4. Schematic illustration. The illustration shows the deep (white arrowhead) and superficial branches (black arrowhead) of radial artery. SRA, superficial radial artery.

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  Fig. 5. Postoperative photograph. The circulation of the entire flap and the tip of the flap (white asterisk) was well maintained.

Reference

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