• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.62-69
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• 1996

Lateral arm flap has been used for the reconstruction of the various defects in hand, head and neck region. This flap is highly dependable as a free flap because of its thin flap thickness, constant vascular anatomy and possibility of osteocutaneous flap and fascial flap. Recently, many authors tried extended approach for vascular pedicle and distal flap extension for bigger defects. In this study, we review previous articles and 14 cases used lateral arm flaps for coverage of the varying defect on head and neck, upper and lower extremities succesfully. In conclusion, lateral arm flap has constant anatomical structure and can overcome the disadvantages such as short pedicle length and limited flap size, then the range of its application can be very widened.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.80-86
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• 1997

The lateral arm flap was reported first by Song et al. in 1982, and Katsaros and colleagues described an anatomic study and clinical cases in 1984. This flap is thin, has relatively constant vascular anatomy, and provides relatively acceptable scar at the donor site. Despite its many advantages its wide application has been limited by its short vascular pedicle with small diameter of lumen, and its small skin paddle. We studied its anatomical structure to get longer length of vascular pedicle, wide diameter and thinner part of flap beyond the lateral condyle through 6 fresh cadaver dissection and dye injection study. We experienced 21 cases of lateral arm free flaps and 26 cases of forearm free flaps from May, 1992 to January, 1996. We compared its usefulness with forearm free flaps in the aspects of donor morbidity, operative factors, quality of flap, and versatility. In conclusion, lateral arm flap can replace the role of forearm flap in most cases so that patient's donor morbidity can be reduced especially in the women.

• Archives of Reconstructive Microsurgery
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• v.17 no.2
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• pp.82-86
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• 2008

Purpose: Soft tissue defect can occur on the posterior aspect of the elbow after trauma or fracture fixation. To cover the defect and maintain elbow functions, various flap surgeries including latissimus dorsi muscle flap, lateral arm flap and radial forearm flap can be performed. We present the clinical results of transposition lateral arm flap for coverage of the elbow defect and discuss the cause of posterior soft tissue necrosis after fracture fixation. Materials and Methods: Two patients who had posterior soft tissue defect of the elbow after open reduction of the fractures around the elbow were treated with transposition lateral arm flap. The mean size of skin defect was 20 $cm^2$. The flap was elevated with posterior radial collateral artery pedicle and transposed to the defect area. Donor defect was covered with split thickness skin graft. The elbow was immobilized for 1 week in extended position and active range of motion was permitted. Results: All two cases of transposition lateral arm flap survived without marginal necrosis. The average range of motion of the elbow was 10~115 degrees. Mayo elbow performance score was 72 and Korean DASH score was 23. Conclusion: When elbow fractures are fixed with three simultaneous plates and screws, skin necrosis can occur on the posterior aspect of the elbow around olecranon area. If the size of skin defect is relatively small, transposition lateral arm flap is very useful option for orthopaedic surgeons without microsurgical technique.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.28-35
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• 2008

The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.

• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.51-57
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• 2004

Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.

• 대한미세수술학회:학술대회논문집
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• 1997.10a
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• pp.133-134
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• 1997

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.745-749
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• 2022

Background Soft tissue defects of the multiple finger present challenges to reconstruction surgeons. Here, we introduce the use of a lateral arm free flap and syndactylization for the coverage of multiple finger soft tissue defects. Methods This retrospective study was conducted based on reviews of the medical records of 13 patients with multiple soft tissue defects of fingers (n = 33) that underwent temporary syndactylization with a microvascular lateral arm flap for temporary syndactylization from January 2010 to December 2020. Surgical and functional outcomes, times of flap division, complications, and demographic data were analyzed. Results Middle fingers were most frequently affected, followed by ring and index fingers. Mean patient age was 43.58 years. The 13 patients had suffered 10 traumas, 2 thermal burns, and 1 scar contracture. Release of temporary syndactyly was performed 3 to 9 weeks after syndactylization. All flaps survived, but partial necrosis occurred in one patient, who required a local transposition flap after syndactylization release. The mean follow-up was 15.8 months. Conclusion Coverage of multiple finger defects by temporary syndactylization using a free lateral arm flap with subsequent division offers an alternative treatment option.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.15-21
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• 1999

Soft tissue defect on heel area of the foot present difficult problems particularly because of anatomic property of plantar surface of the foot. There is a paucity of available local tissue in the foot for coverage. In addition to having little expandable tissue, the foot's plantar surface has a unique structure, making its replacement especially challenging. Plantar skin is attached to the underlying bone by fibrous septa, preventing shear of the soft-tissue surfaces from the underlying skeleton. Plantar surface of foot is in constant contact with the environment. Protective sensibility also would be maintained or restored in the ideal reconstruction. So the ideal flap for reconstruction of the heel should include thin, durable hairless skin with potential for reinnervation. The aim of this article is to present a clinical experience of free lateral arm neurosensory flap for reconstruction of the heel. From March 1995 to December 1997, a total 16 lateral arm free flaps were performed to soft tissue defects on the weight-bearing area of the hindfoot. we used tibial nerve as recepient nerve in 11 and calcaneal branch of tibial nerve in 5 for restoration of sensibility of flap. All cases survived completely. A static two-point discrimination of 14 to 34mm was detected in the flap. Radial nerve palsy which was caused by hematoma in donor site occured in one case, but recorverd in 3 weeks later completely. In conclusion, the lateral arm free flaps are versatile, reliable and sensible cutaneous flap and especially indicated for soft tissue defect on plantar surface of the hindfoot which are not good indications for other better-known flaps.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.4
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• pp.286-292
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• 2012

The lateral upper arm flap (LUAF) was initially described by in 1982 by Song et al. as a simple skin flap, addressing the availability of cutaneous nerves for anastomoses. Katsaros et al., reported the use of a lateral upper arm skin flap, but also considered using it as a composite graft. The LUAF for the oral and maxillofacial reconstruction has several advantages over other flaps, such as constant anatomy, good color match and texture, thin design and plasticity. There is no functional limitation in the donor arm, such as strength and extension, and donor defects can be closed primarily with a linear scar, even when a flap of up to 8 cm in width is taken. For a better understanding of LUAF as a routine reconstructive option in moderate defect of maxillofacial region, the constant anatomical findings must be learned and memorized by young doctors during the specialized training course for the Korean national board of oral and maxillofacial surgery. This article review the anatomical basis of LUAF with Korean language.

• 대한미세수술학회:학술대회논문집
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• 1996.10a
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• pp.163-163
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• 1996