| |
 FIG. 14-34. An osteocutaneous forearm flap was outlined and a strut of bone between the radial styloid and insertion of pronator teres was planned.
 FIG. 14-35. Skin flap is elevated and bone segment and musculoseptal cuff isolated.
 FIG. 14-36. The bone was osteotomized in two locations to allow contouring to recreate the mentum.
 FIG. 14-37. Flap is isolated.
 FIG. 14-38. Postoperative x ray shows AO plates used to fix the radial bone at each end, and interosseous wires combined with bone grafts at the osteotomy sites.
 FIG. 14-39. Postoperatively, the chin prominence is reasonably well preserved. The bone graft healed well. Side view.
 FIG. 14-40. Front view.
 FIG. 14-41. The forearm defect has not been a problem to the patient.
 FIG. 14-42. The patient was fitted for dentures, which sit well on his reconstructed alveolus.
 FIG. 14-43. Pre- and postoperative radiographs show callus and thickening of the remaining cortex of the distal radius. Early radiograph.
|
|
 FIG. 14-44. Late radiograph.
CASE 6
A 50-year-old man had a lesion on the anterior floor of his mouth resected.
 FIG. 14-45. The upper portion of the lip was preserved, but a defect involving skin, the anterior mandible, and the overlying mucosa remained. The patient had an immediate bipaddled osteocutaneous flap raised from his forearm. One paddle was used to cover the reconstructed portion of the mandible. The other was used to provide external cover.
 FIG. 14-46. Postoperatively, the patient has done well and will soon be ready for denture fitting. Intraoral view.
 FIG. 14-47. The chin prominence has been well maintained. The flap has tolerated postoperative radiotherapy.
References
1. Yang, G., Chen, B., Gao, Y., et al.: Forearm free skin flap transplantation. Nat. Med. J. China. 61:139, 1981.
2. Muhlbauer, W., Herndl, E., and Stock, W.: The forearm flap. Plast. Reconstr. Surg. 70:336, 1982.
next page... |
