Skip to main content

Advertisement

SpringerLink
Log in

Lateral arm flap: indications and techniques

  • General Review • UPPERLIMB - MICROSURGERY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Song R, Song Y, Yu Y, Song Y (1982) The upper arm free flap. Clin Plast Surg 9:27–35

    CAS  PubMed  Google Scholar 

  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 58:173–178

    Article  CAS  PubMed  Google Scholar 

  3. Culbertson JH, Mutimer K (1987) The reverse lateral upper arm flap for elbow coverage. Ann Plast Surg 18:62–68

    Article  CAS  PubMed  Google Scholar 

  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 31:212–216

    Article  PubMed  Google Scholar 

  5. Katsaros J, Schusterman M, Beppu M, Banis JC, Acland RD (1984) The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg 12:489–500

    Article  CAS  PubMed  Google Scholar 

  6. Katsaros J, Tan E, Zoltie N, Barton M, Venugopalsrinivasan, Venkataramakrishnan (1991) Further experience with the lateral arm free flap. Plast Reconstr Surg 87:902–910

    Article  CAS  PubMed  Google Scholar 

  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 10:177–185

    Article  CAS  PubMed  Google Scholar 

  8. Arnež ZM, Kersnič M, Smith RW, Godina M (1991) Free lateral arm osteocutaneous neurosensory flap for thumb reconstruction. J Hand Surg Am 16:395–399

    Article  Google Scholar 

  9. Chen H, El-Gammal TA (1997) The lateral arm fascial free flap for resurfacing of the hand and fingers. Plast Reconstr Surg 99:454–459

    Article  CAS  PubMed  Google Scholar 

  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 14:39–48

    Article  CAS  PubMed  Google Scholar 

  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 33:31–39

    Article  PubMed  Google Scholar 

  12. Ninkovic M, Disa JJ (2009) Flaps and reconstructive surgery. In: Wei FC, Mardini S (eds) Flaps and reconstructive surgeons. pp 305–319

  13. Kuek LBK, Chuan TL (1991) The extended lateral arm flap: a new modification. J Reconstr Microsurg 7:167–173

    Article  CAS  PubMed  Google Scholar 

  14. Lanzetta M, Bernier M, Chollet A, St-Laurent JY (1997) The lateral forearm flap: an anatomic study. Plast Reconstr Surg 99:460–464

    Article  CAS  PubMed  Google Scholar 

  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 54:153–159

    Article  CAS  PubMed  Google Scholar 

  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 16:204–214

    Article  CAS  PubMed  Google Scholar 

  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 86:1138–1145

    Article  CAS  PubMed  Google Scholar 

  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 21:107–112

    Article  PubMed  Google Scholar 

  19. Rivet D, Buffet M, Martin D, Waterhouse N, Kleiman L, Delonca DBJ (1987) The lateral arm flap: an anatomic study. J Reconstr Microsurg 3:121–132

    Article  CAS  PubMed  Google Scholar 

  20. Scheker LR, Harold HE, Hanel DP (1987) Lateral arm composite tissue transfer to ipsilateral hand defects. J Hand Surg Am 12:665–672

    Article  CAS  PubMed  Google Scholar 

  21. Teoh LC, Khoo DB, Lim BH, Yong FC (1995) Osteocutaneous lateral arm flap in hand reconstruction. Ann Acad Med Singap 24:15–20

    CAS  PubMed  Google Scholar 

  22. Haas F, Rappl T, Koch H, Pittler P, Scharnagl E (2003) Free osteocutaneous lateral arm flap: anatomy and clinical applications. Microsurgery 23:87–95

    Article  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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 23:285–289

    Article  Google Scholar 

  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 25:723–729

    Article  PubMed  Google Scholar 

  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 53:215–219

    Article  CAS  PubMed  Google Scholar 

  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 17:189–192

    Article  CAS  Google Scholar 

  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 7:163–171

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, University of Patras, School of Medicine, University Hospital of Patras, Papanikolaou 1, 26504, Rio, Patras, Greece

    Zinon T. Kokkalis, Efstratios Papanikos & Andreas Panagopoulos

  2. Private practice, Athens, Greece

    George A. Mazis

  3. Department of Plastic Surgery, University of Tennessee Health Sciences Center, Memphis, TN, USA

    Petros Konofaos

Authors
  1. Zinon T. Kokkalis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Efstratios Papanikos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George A. Mazis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andreas Panagopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Petros Konofaos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zinon T. Kokkalis.

Ethics declarations

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kokkalis, Z.T., Papanikos, E., Mazis, G.A. et al. Lateral arm flap: indications and techniques. Eur J Orthop Surg Traumatol 29, 279–284 (2019). https://doi.org/10.1007/s00590-019-02363-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-019-02363-0

Keywords

Search

Navigation