• Archives of Plastic Surgery
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• v.34 no.5
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• pp.593-598
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• 2007

Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.

• Korean Journal of Head & Neck Oncology
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• v.38 no.1
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• pp.53-57
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• 2022

Reconstruction of subtotal maxillectomy defects with columella deficit is challenging. We report a unique case of facial reconstruction using a free radial forearm flap and a free preauricular flap for the maxillectomy and columella deficit. A 73-year-old woman was diagnosed with recurrent sebaceous carcinoma of the nose. We performed wide excision, including areas of the right cheek, nose, upper lip, maxilla, and columella. The resultant subtotal maxillectomy defect was reconstructed using a three-dimensional flap. First, a free radial forearm flap was transfered to resurface the nasal, oral, and external facial side. Second, a preauricular flap was positioned into the columella defect and anastomosed with the distal portion of the radial forearm flap pedicle. The two flaps survived, and the patient recovered uneventfully. We believe the radial forearm and preauricular double free flaps with the pedicle connection method were effective in reconstructing the present case of subtotal maxillectomy defect.

• 대한미세수술학회:학술대회논문집
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• 1995.11a
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• pp.81.2-81.2
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• 1995

• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.38-44
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• 2021

Background: The free flap surgical method is useful for the reconstruction of head and neck defects. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 30 years. Methods: Between 1989 and 2018, a total of 866 free flap procedures were performed on 859 patients with head and neck defects, including 7 double free flaps. The causes of vascular crisis and salvage rate were analyzed, and the total flap survival rate calculated among these patients. Additionally, the survival and complication rates for each flap type were compared. Results: The 866 cases included 557 radial forearm flaps, 200 anterolateral thigh flaps, 39 fibular osteocutaneous flaps, and 70 of various other flaps. The incidence of the vascular crisis was 5.1%; its most common cause was venous thrombosis (52.3%). Salvage surgery was successful in 52.3% of patients, and the total flap survival rate was 97.6%. The success rate of the radial forearm flap was higher than of the anterolateral flap (p< 0.01), and the primary sites of malignancy were the tongue, tonsils, and hypopharynx, respectively. Conclusion: The free flap technique is the most reliable method for head and neck reconstruction; however, the radial forearm free flap showed the highest success rate (98.9%). In patients with malignancy, flap failure was more common in the anterolateral thigh (5.5%) and fibular (5.1%) flaps.

• Korean Journal of Head & Neck Oncology
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• v.31 no.1
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• pp.5-8
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• 2015

Backgrounds: The purpose of this study was to compare full thickness skin graft with inguinal skin to split thickness skin graft for coverage of the radial forearm free flap donor site. Patients and Methods: 25 patients who was reconstructed with radial forearm free flap for head and neck cancer were reviewed retrospectively. Results: The graft loss rates of full thickness skin graft were less than split thickness skin graft or split thickness skin graft with dermal substitutes. The recovery times of donor site and skin graft donor site of full thickness skin graft were also shorter than split thickness skin graft or split thickness skin graft with dermal substitutes. Skin texture and aesthetic results of donor site were improved and complications as itching and pain sensation were decreased. Conclusion: Full thickness skin grafts with inguinal skin should be considered for patients requiring a radial forearm free flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.93-101
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• 2011

Reconstruction following a resection of malignant oral cavity tumors is one of the most difficult problems in recent oral oncology. The radial forearm free flap (RFFF) is a thin, pliable soft tissue flap with large-caliber vessels for microvascular anastomosis. Its additional advantages include consistent flap vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with a tumor resection. For a better understanding of RFFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of RFFF in the Korean language.

• Archives of Reconstructive Microsurgery
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• v.12 no.2
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• pp.119-124
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• 2003

Introduction : The purpose is a retrospective evaluation of the clinical results of the radial forearm flap transfer for foot reconstruction. Materials and methods : We evaluated 21 cases with medical records including etiology, wound dimension, presence of infection, associated fracture, ischemic time of free flap, complication of donor and recipient site. The final results were evaluated with our clinical score (walking, shoe-in, cosmetic). Results : Defects were located on the heel (12 cases), dorsum of foot (4 cases) and sole (5 cases). Mean wound dimension was $7.56{\times}6.0cm$, and mean ischemic time of free flap was 94.5minute. There were superficial skin necrosis (1 case), recurrent ulceration (2 cases) in recipient site, and no complication in donor site but complaint about cosmetic problem (3 cases). The clinical score showed excellent in 14 cases, good in 4 cases, fair in 1 case and poor in 2 cases. Conclusion : We consider the radial forearm flap could provid the stable and durable restoration of normal foot contour without debulking in the foot reconstruction and achieved normal ambulation and cosmetic satisfaction.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.198-204
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• 2001

Background and Objectives: As the laryngopharyngeal cancer is usually found at a advanced stage, it is difficult to get a wide surgical margin that preserves functional aspect and that is oncologically safe simultaneously. There were many operative technique to fulfill this principle, but none were satisfactory. Recently there were some reports about glottic and pharyngeal reconstruction using radial forearm free flap(RFFF) with palmaris longus tendon, which provided satisfactory oncologic and functional results. We attempted to perform this technique and to test usefulness at patients of laterally localized laryngopharyngeal tumor. Materials and Methods: Three patients were reconstructed glottis and pharynx using radial forearm free flap with palmaris longus tendon. Two hypopharyngeal cancer (T2N0M0) patients were performed wide vertical hemilaryngopharyngectomy and one supraglottic cancer(T2N0M0) patient was performed horizontovertical laryngopharyngectomy. Deglutitional function was evaluated with modified barium swallow and speech function was evaluated by speech pathologist. Results: Mean follow-up time was 29.3 months. There were no cancer recurrence. Their speech was satisfy-actory at social communication and oral feeding. They all have a complete oral nutrition from 26 days to 53 days. Decanulation time was from 71 days to 30 months. Conclusion: Glottic and pharyngeal reconstruction with radial forearm free flap could be accepted as a promising technique which offers a wide resection margin but satisfactory functional result in lateralized laryngohypopharyngeal cancer patients.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.46-49
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• 2002

Background: Free flaps have become a very important role in the ablative head and neck surgery with functional preservation of defect sites. The forearm free flap has many advantage of lack of bulk, ease of dissection, vascularity, and malleability. Patients and Methods: A review of 51 radial forearm free flaps performed between may 1990 and feburary 2001 at the Korea University was undertaken to determine outcome. Patient age ranged 27 to 72 years (mean 56). There were 44 men and 7 women. The most prevalent neoplasm was squamous cell carcinoma. Results: The tans verse cervical artery and the external jugular vein were the most frequent receipient sites for microvascular anastomosis. Total flap loss occurred in 2 cases (4%) and other complications were seen in 42%. Fifteen patients received preoperative irradiation and the complication was higher than non-irradiation patients, but statistically not significant. Conclusion: The radial forearm free flap offers a variety of reconstructive options for head and neck. Its low flap loss and complication rates offer the best choice for reconstruction of defect of head and neck malignancy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.248-255
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• 2013

Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.