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29 Cards in this Set
- Front
- Back
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What size defects are appropriate for this type of flap?
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Small to medium size
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What is the arterial blood supply?
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Radial artery
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What is the venous out flow?
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Vena comitantes or
Cephalic |
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What is the longest vascularized segment of radius that can be harvested
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12 cm
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Is the blood supply axial or random?
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Axial- a known vessel that runs at the base of the flap
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Who first describe the RFFF and when?
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Song
1982 |
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Why is it important not to violate or remove the paratenon when elevating the flap?
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a. It helps to ensure adequate acceptance of the skin graft
b. It prevents adhesions which limit flexor ROM and strength of the hand |
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What is the disadvantage of harvesting the flap from the distal forearm?
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It leave the tendons exposed which makes a poor recipient bed from skin grafts.
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In the distal forearm, between what structures does the radial artery lie?
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The tendons of the brachioradialis and flexor carpi radialis
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Care must be taken during the lateral dissection to protect what structure?
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Cephalic vein
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Care must be taken during the medial dissection to protect what structure?
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Ulnar artery
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What structure can be harvested to provide lower lip reconstruction and support?
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Palmaris longus tendon
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What structure can be harvested to provide increased bulk of flap?
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Brachioradialis muscle
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What nerve is typically harvested to provide a sensate flap, and from which cervical nerve(s) does it branch?
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Antebrachial cutaneous nerve
C5-6 |
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What nerve runs along the radial artery in the proximal half of the forearm? What is its course and where does it divide?
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Superficial brach of the lateral cutaneous nerve (radial nerve). Half way along the deep aspect of the brachioradialis it courses laterally while the artery runs medially.
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What is the complication rate of RFFF?
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25-30%
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What is the rate of RFFF failure?
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2-3%
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What is the success rate of all head and neck free-flaps?
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92-98%
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Donor site complications:
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Failure of skin graft take
Radius fx Decreased hand strength/ROM Paresthesias Infection Poor aesthetics |
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Describe the anatomy behind the Allen's test?
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Radial artery supplies the deep palmar arch
Ulnar artery supplies the superficial palmar arch |
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What is the average length of the radial artery from ACF to wrist?
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18-20 cm
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What is the average diameter of the radial artery?
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2-2.5 mm
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What is the deep venous supply to the RFFF?
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Vena comitantes
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What is the superficial venous supply to the RFFF?
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Cephalic vein and other large diameter veins
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Describe the Allen's test
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Pt clenches fist for 30 seconds.
Occlude both the ulnar and radial arteries with no more than 11 pounds Elevate and open hand (blanched) Release ulnar pressure and watch for return of circulation within 7 seconds |
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What is considered a positive Allen test? What does it indicate?
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No return of ciculation within 7 seconds.
Inadequate ulnar artery collateral circulation |
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What are the limitations (diameter and length) in radial bone harvest?
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No more than one-third the diameter of the radius and no longer than approximately 10 to 11 cm
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Radial bone graft is limited and thus is best reserved for which area of the mouth?
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Maxilla, especially the anterior aspect.
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If radial bone harvest is performed, what is often performed on the donor site bone?
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Plated
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