Advertisement

Lateral arm flap: indications and techniques

  • Zinon T. KokkalisEmail author
  • Efstratios Papanikos
  • George A. Mazis
  • Andreas Panagopoulos
  • Petros Konofaos
General Review • UPPERLIMB - MICROSURGERY
  • 30 Downloads

Abstract

The lateral arm flap (LAF) is a popular flap transfer, which can be applied in many procedures. It was first described in 1982, and till then, even more clinical applications are suggested. It can be used as a free fasciocutaneous or fascial flap to cover small- to medium-sized soft tissue defects in head and neck but also in upper and lower extremity reconstruction, or as an osteocutaneous flap when vascularized bone graft is needed. We present the indications and contraindications, the advantages and disadvantages, as well as the step-by-step technique of harvesting a fasciocutaneous and an osteocutaneous flap and its complications. We conclude that the LAF is a reliable and versatile tool for reconstructive surgery, due to its anatomical characteristics and the low complication rate.

Keywords

Lateral arm flap Reconstructive surgery Microsurgery Defects 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Song R, Song Y, Yu Y, Song Y (1982) The upper arm free flap. Clin Plast Surg 9:27–35Google Scholar
  2. 2.
    Ulusal BG, Lin Y-T, Ulusal AE, Lin C-H (2007) Free lateral arm flap for 1-stage reconstruction of soft tissue and composite defects of the hand. Ann Plast Surg 58:173–178CrossRefGoogle Scholar
  3. 3.
    Culbertson JH, Mutimer K (1987) The reverse lateral upper arm flap for elbow coverage. Ann Plast Surg 18:62–68CrossRefGoogle Scholar
  4. 4.
    Türegün M, Nisanci M, Duman H, Aksu M, Şengezer M (2005) Versatility of the reverse lateral arm flap in the treatment of post-burn antecubital contractures. Burns 31:212–216CrossRefGoogle Scholar
  5. 5.
    Katsaros J, Schusterman M, Beppu M, Banis JC, Acland RD (1984) The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg 12:489–500CrossRefGoogle Scholar
  6. 6.
    Katsaros J, Tan E, Zoltie N, Barton M, Venugopalsrinivasan, Venkataramakrishnan (1991) Further experience with the lateral arm free flap. Plast Reconstr Surg 87:902–910CrossRefGoogle Scholar
  7. 7.
    Akinci M, Ay S, Kamiloglu S, Ercetin O (2005) Lateral arm free flaps in the defects of the upper extremity–a review of 72 cases. Hand Surg 10:177–185CrossRefGoogle Scholar
  8. 8.
    Arnež ZM, Kersnič M, Smith RW, Godina M (1991) Free lateral arm osteocutaneous neurosensory flap for thumb reconstruction. J Hand Surg Am 16:395–399CrossRefGoogle Scholar
  9. 9.
    Chen H, El-Gammal TA (1997) The lateral arm fascial free flap for resurfacing of the hand and fingers. Plast Reconstr Surg 99:454–459CrossRefGoogle Scholar
  10. 10.
    Harpf C, Papp C, Ninković M, Anderl H, Hussl H (1998) The lateral arm flap: review of 72 cases and technical refinements. J Reconstr Microsurg 14:39–48CrossRefGoogle Scholar
  11. 11.
    Ninković M, Harpf C, Gunkel A, Schwabegger A, Thumfart W, Anderl H (1999) One-stage reconstruction of defects in the hypopharyngeal region with free flaps. Scand J Plast Reconstr Surg Hand Surg 33:31–39CrossRefGoogle Scholar
  12. 12.
    Ninkovic M, Disa JJ (2009) Flaps and reconstructive surgery. In: Wei FC, Mardini S (eds) Flaps and reconstructive surgeons. pp 305–319Google Scholar
  13. 13.
    Kuek LBK, Chuan TL (1991) The extended lateral arm flap: a new modification. J Reconstr Microsurg 7:167–173CrossRefGoogle Scholar
  14. 14.
    Lanzetta M, Bernier M, Chollet A, St-Laurent JY (1997) The lateral forearm flap: an anatomic study. Plast Reconstr Surg 99:460–464CrossRefGoogle Scholar
  15. 15.
    Hage JJ, Woerdeman LAE, Smeulders MJC (2005) The truly distal lateral arm flap: rationale and risk factors of a microsurgical workhorse in 30 patients. Ann Plast Surg 54:153–159CrossRefGoogle Scholar
  16. 16.
    Hennerbichler A, Etzer C, Gruber S, Brenner E, Papp C, Gaber O (2003) Lateral arm flap: analysis of its anatomy and modification using a vascularized fragment of the distal humerus. Clin Anat 16:204–214CrossRefGoogle Scholar
  17. 17.
    Yousif NJ, Warren R, Matloub HS, Sanger JR (1990) The lateral arm fascial free flap: its anatomy and use in reconstruction. Plast Reconstr Surg 86:1138–1145CrossRefGoogle Scholar
  18. 18.
    Karamürsel S, Baǧdatlý D, Markal N, Demir Z, Çelebioǧlu S (2005) Versatility of the lateral arm free flap in various anatomic defect reconstructions. J Reconstr Microsurg 21:107–112CrossRefGoogle Scholar
  19. 19.
    Rivet D, Buffet M, Martin D, Waterhouse N, Kleiman L, Delonca DBJ (1987) The lateral arm flap: an anatomic study. J Reconstr Microsurg 3:121–132CrossRefGoogle Scholar
  20. 20.
    Scheker LR, Harold HE, Hanel DP (1987) Lateral arm composite tissue transfer to ipsilateral hand defects. J Hand Surg Am 12:665–672CrossRefGoogle Scholar
  21. 21.
    Teoh LC, Khoo DB, Lim BH, Yong FC (1995) Osteocutaneous lateral arm flap in hand reconstruction. Ann Acad Med Singap 24:15–20Google Scholar
  22. 22.
    Haas F, Rappl T, Koch H, Pittler P, Scharnagl E (2003) Free osteocutaneous lateral arm flap: anatomy and clinical applications. Microsurgery 23:87–95CrossRefGoogle Scholar
  23. 23.
    Georgescu AV, Matei IR (2018) Propeller perforator flaps in forearm and hand reconstruction. Eur J Orthop Surg Traumatol.  https://doi.org/10.1007/s00590-018-2323-7 Google Scholar
  24. 24.
    van Waes OJF, Halm JA, Vermeulen J, Ashford BG (2013) “The Practical Perforator Flap”: the sural artery flap for lower extremity soft tissue reconstruction in wounds of war. Eur J Orthop Surg Traumatol 23:285–289CrossRefGoogle Scholar
  25. 25.
    Acar MA, Güleç A, Aydin BK, Erkoçak ÖF, Elmadag M, Türkmen F (2015) Reconstruction of dorsal hand and finger defects with reverse radial fasciocutaneous forearm flaps. Eur J Orthop Surg Traumatol 25:723–729CrossRefGoogle Scholar
  26. 26.
    Hamdi M, Coessens B-C (2000) Evaluation of the donor site morbidity after lateral arm flap with skin paddle extending over the elbow joint. Br J Plast Surg 53:215–219CrossRefGoogle Scholar
  27. 27.
    Graham B, Adkins P, Scheker LR (1992) Complications and morbidity of the donor and recipient sites in 123 lateral arm flaps. J Hand Surg Am 17:189–192CrossRefGoogle Scholar
  28. 28.
    Sauerbier M, Germann G, Giessler GA, Salakdeh MS, Döll M (2012) The free lateral arm flap—a reliable option for reconstruction of the forearm and hand. Hand 7:163–171CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopaedics, University of Patras, School of MedicineUniversity Hospital of PatrasRio, PatrasGreece
  2. 2.Private practiceAthensGreece
  3. 3.Department of Plastic SurgeryUniversity of Tennessee Health Sciences CenterMemphisUSA

Personalised recommendations