Patient Self-Report of Disability of the Upper Extremity following Osteocutaneous Radial Forearm Free Flap Harvest

Abstract

Objective reductions in wrist, forearm, and/or thumb range of motion are frequent after harvest of an osteocutaneous radial forearm free flap. Wrist range of motion has the greatest impact on patient self-report of disability and may in a minority of patients be perceived as causing a clinically significant disability.

Upper extremity morbidity after radial forearm flap harvest: a prospective study

“…Studies have variously reported 25% of patients with forearm disabilities, 4 none or minimal disability in the majority of patients (58.3%), 8 and moderate or extreme dysfunction in most cases (exact data not available). 5 This between-study variation may be due to differences in sample size.…”

“…9,[21][22][23][24] Some studies have focused on wrist mobility, but the effect of RFF flap harvest on this parameter is unclear. [7][8][9][10] In addition, it has been shown that objective measurements do not accurately reflect the patient's experience. 4,6 This may be because the majority of RFF flaps are harvested from the non-dominant arm, and the reduction in wrist motion was not severe enough to impact significantly on daily life.…”

“…This scale has been validated in several studies. 5,8,11 There are few prospective studies regarding the effect of RFF flap reconstruction on function. When preoperative and postoperative forearms were compared with nonoperated forearms, there were statistically significant differences in wrist flexion, pinch strength and sensation, but no subjective complaints of loss of function by any patient.…”

“…RFF flaps have been found to have widely varying effects on hand function, [4][5][6][7][8][9][10][11] but studies of their effect on upper extremity function are few and have failed to take into consideration the possible effect of neck dissection. 4,5,8,9 The aim of the present prospective matched-pair study was to determine the effect of the RFF flap on upper extremity function.…”

“…4,5,8,9 The aim of the present prospective matched-pair study was to determine the effect of the RFF flap on upper extremity function.…”