Versatility of lateral arm flap for hand reconstruction—a
Received: 11 September 2015 /Accepted: 26 May 2016 / Published online: 2 July 2016
Springer-Verlag Berlin Heidelberg 2016
Background The lateral arm free flap (LAFF) has several
advantages in hand reconstruction due to multiple fac-
tors. We aimed to show the versatility of LAFF in
treating hand defects.
Methods A retrospective analysis of all LAAF for hand
reconstruction carried out at our institutions between
August 2006 and August 2012 was undertaken.
Clinical records were reviewed with respect to patients’
age and gender, size and location of defect, type and
size of flaps, and complications.
Results Twenty-four hand defects were reconstructed
using LAFF. These included 15 cutaneous flaps, 8 fas-
cial flaps, and 1 osteocutaneous flap. All flaps survived
well except for one case that developed arterial insuffi-
ciency and required anastomotic revision. Primary clo-
sure of the donor site was possible in all patients. No
complications occurred during the healing procedure.
Conclusions The free lateral arm flap is a versatile and
reliable option for defect coverage at the hand for
small- and medium-size defects. It can be raised as a
cutaneous, fascial, or osteocutaneous flap. Several
advantages favor the use of lateral arm flap in hand
reconstruction. These include preservation of major
arm blood vessels, its constant vascular anatomy, long
pedicle, and low donor site morbidity.
Level of Evidence: Level IV, therapeutic study.
In 1982, Song et al.  introduced the lateral arm flap where it
became the workhorse for the reconstruction of small- to
medium-sized defects of the hand. Katsaros et al. further
reported anatomical details and clinical applications of the flap
in 1984 and it subsequently gained popularity in the west .
The lateral arm flap is a septocutaneous flap that has distinc-
tive features including a constant vascular anatomy that orig-
inates from the posterior radial collateral artery. Furthermore,
it has the advantage of preserving major arm blood vessels .
The flap versatility is based on its harvest as fascial,
fasciocutaneous, osteocutaneous, neurosensory, or as a
tendon-flap with the incorporation of the triceps tendon. In
addition, the caliber of the lateral arm flap perforator is
proportionate to the size of the digital and common digital
arteries, making it more suitable over other flaps in hand
reconstruction [4, 5].
* Abeer Kalandar
Hand and Microsurgery Center, Department of Plastic and
Reconstructive Surgery, Kwang-Myung Sung-Ae General hospital,
Gwang- Myeong, South Korea
Plastic and Reconstructive Surgery, Al-Babtain Center, Kuwait
Jamal Abdul Naser Street, Sabah Medical Region, Albabtain Center
for Burns, Plastic and Reconstructive Surgery, Ministry of
Health-Kuwait, Eastern Granada Road., Kuwait city, Kuwait
Eur J Plast Surg (2016) 39:435–440