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

Objective To determine the effect of radial forearm free (RFF) flap harvest on patient-reported postoperative upper extremity disability. Methods Patients undergoing RFF flap reconstruction following resection of head and neck cancer were recruited and matched with similar patients undergoing non-RFF reconstruction. All subjects completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire preoperatively and at least 1 year postoperatively. Results Postoperative DASH scores were significantly higher (more severe disability) in patients undergoing RFF flap reconstruction (6.935.54; n=52) compared with those undergoing non-RFF flap surgeries (2.95 +/- 4.42; n=52). Preoperative DASH score, flap size, patient age and tumour stage were significantly correlated with postoperative DASH score. Conclusion Excluding the effect of neck dissection, RFF flap reconstruction has a significant deleterious effect on upper extremity function.