European Journal of Plastic Surgery

, Volume 35, Issue 1, pp 1–4 | Cite as

Reversed radial forearm flap: an ad hoc flap for hand reconstruction

  • Ahmed Hassan El-SabbaghEmail author
  • Ahmed Abd El-Moaty Zeina
  • Ahmed Abd El-Gleil Khalil
  • Hossam El-Dein Ismail
  • Loai El-Sayed El-Bassiony
  • Al-Moddather Mohamed El-Hadidy
  • Ahmed Bahaa El-Din


Complex wounds of the hand and vital structures are important to reconstruct. They should be covered as soon as possible in order to maintain the function of the hand. The reversed radial forearm flap is a versatile option for hand reconstruction. Reversed radial forearm flaps were harvested in 15 cases. Doppler ultrasound was used in all cases to evaluate the vascular status of the flap. No complications were observed in this series. All skin grafts healed well. The reversed radial forearm flap is a workhorse tool for the coverage of the hand.


Reversed radial forearm flap Dorsum of hand Palm of hand Thumb 

Supplementary material

Movie 1

Movement of the burnt hand after coverage of the burnt dorsum with reversed radial forearm flap (AVI 15,340 kb)


  1. 1.
    Flugel A, Kehrer A, Heitmann C, Germann G, Sauerbier M (2005) Coverage of soft tissue defects of the hand with free fascial flaps. Microsurgery 25:47–53PubMedCrossRefGoogle Scholar
  2. 2.
    Gohla T, Kehrer A, Holle G, Megerle K, Germann G, Sauerbier M (2007) Functional and aesthetic refinements of free flap coverage at the dorsum of the hand and distal forearm. Unfallchirurg 110:5–13PubMedCrossRefGoogle Scholar
  3. 3.
    McGregor AD (1987) The free radial forearm flap—the management of the secondary defect. Br J Plast Surg 40:83–85PubMedCrossRefGoogle Scholar
  4. 4.
    Soutar DS, Tanner NSB (1984) The radial forearm flap in the management of soft tissue injuries of the hand. Br J Plast Surg 37:18–26PubMedCrossRefGoogle Scholar
  5. 5.
    Biemer E, Stock W (1983) Total thumb reconstruction: a one-stage reconstruction using an osteocutaneous forearm flap. Br J Plast Surg 36:52–55PubMedCrossRefGoogle Scholar
  6. 6.
    Foucher G, van Genechten F, Merle N, Michon J (1984) A compound radial artery forearm flap in hand surgery: an original modification of the Chinese forearm flap. Br J Plast Surg 37:139–148PubMedCrossRefGoogle Scholar
  7. 7.
    Gilbert DA (1981) An overview of flaps for hand and forearm reconstruction. Clin Plast Surg 8:129–139PubMedGoogle Scholar
  8. 8.
    Knobloch K, Gohritz A, Spies M, Altintas MA, Rennekampff HO, Vogt PM (2009) External fixation in complicated groin flap surgery. Plast Reconstr Surg 124:268e–269ePubMedCrossRefGoogle Scholar
  9. 9.
    Jin YT, Guan WX, Shi TM, Quian YL, Xu LG, Chang TS (1985) Reversed island forearm fascial flap in hand surgery. Ann Plast Surg 15:340–347PubMedCrossRefGoogle Scholar
  10. 10.
    Page R, Chang J (2006) Reconstruction of hand soft-tissue defects: alternatives to the radial forearm fasciocutaneous flap. J Hand Surg Am 31:847–856PubMedCrossRefGoogle Scholar
  11. 11.
    Richardson D, Fisher SE, Vaughan ED, Brown JS (1997) Radial forearm flap donor-site complications and morbidity: a prospective study. Plast Reconstr Surg 99:109–115PubMedCrossRefGoogle Scholar
  12. 12.
    Huang CH, Chen HC, Huang YL, Mardini S, Feng GM (2004) Comparison of the radial forearm flap and the thinned anterolateral thigh cutaneous flap for reconstruction of tongue defects: an evaluation of donor-site morbidity. Plast Reconstr Surg 114:1704–1710PubMedCrossRefGoogle Scholar
  13. 13.
    De Bree R, Hartley C, Smeele LE, Kuik DJ, Quak JJ, Leemans CR (2004) Evaluation of donor site function and morbidity of the fasciocutaneous radial forearm flap. Laryngoscope 114:1973–1976PubMedCrossRefGoogle Scholar
  14. 14.
    Weinzweig N, Chen L, Chen ZW (1994) The distally based radial forearm fasciosubcutaneous flap with preservation of the radial artery: an anatomic and clinical approach. Plast Reconstr Surg 94:675–684PubMedCrossRefGoogle Scholar
  15. 15.
    Jones BM, O'Brien CJ (1985) Acute ischaemia of the hand resulting from elevation of a radial forearm flap. Br J Plast Surg 38:396–397PubMedCrossRefGoogle Scholar
  16. 16.
    Nunoo-Mensah J (1998) An unexpected complication after harvesting of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 66:929–931PubMedCrossRefGoogle Scholar
  17. 17.
    Fox AD, Whiteley MS, Phillips-Hughes J, Roake J (1999) Acute upper limb ischemia: a complication of coronary artery bypass grafting. Ann Thorac Surg 67:535–536, discussion 536–537PubMedCrossRefGoogle Scholar
  18. 18.
    Heller F, Wei W, Wei FC (2004) Chronic arterial insufficiency of the hand with fingertip necrosis 1 year after harvesting a radial forearm free flap. Plast Reconstr Surg 114:728–731PubMedCrossRefGoogle Scholar
  19. 19.
    Higgins JP, Orlando GS, Chang P, Serletti JM (2001) Hypothenar hammer syndrome after radial forearm flap harvest: a case report. J Hand Surg Am 26:772–775PubMedCrossRefGoogle Scholar
  20. 20.
    Kleinman WB, O'Connell SJ (1993) Effects of the fasciocutaneous radial forearm flap on vascularity of the hand. J Hand Surg Am 18:953–958PubMedCrossRefGoogle Scholar
  21. 21.
    Suominen S, Ahovuo J, Asko-Seljavaara S (1996) Donor site morbidity of radial forearm flaps: a clinical and ultrasonographic evaluation. Scand J Plast Reconstr Surg Hand Surg 30:57–61PubMedCrossRefGoogle Scholar
  22. 22.
    Lorenzetti F, Giordano S, Suominen E, Asko-Seljavaara S, Suominen S (2010) Intraoperative hemodynamic evaluation of the radial and ulnar arteries during free radial forearm flap procedure. J Reconstr Microsurg 26:73–77PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Ahmed Hassan El-Sabbagh
    • 1
    Email author
  • Ahmed Abd El-Moaty Zeina
    • 1
  • Ahmed Abd El-Gleil Khalil
    • 1
  • Hossam El-Dein Ismail
    • 1
  • Loai El-Sayed El-Bassiony
    • 1
  • Al-Moddather Mohamed El-Hadidy
    • 1
  • Ahmed Bahaa El-Din
    • 1
  1. 1.Mansoura University HospitalMansouraEgypt

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