The extended lateral arm flap: a new modification.

The lateral arm flap has been one of the mainstays in the armamentarium of microvascular reconstructive surgeons, especially in the cover of small to medium-sized defects. Despite its many advantages, its widespread application has been limited by its small skin paddle. As a result of detailed anatomic and dye-injection studies, it is possible to determine the actual extent of the cutaneous vascular supply of this flap, which is derived from the posterior radial collateral artery. This artery is found to extend significantly beyond the elbow and into the radial aspect of the upper forearm and, through clinical illustrations, it can be shown that a much larger flap can be harvested and used in a manner that is more versatile than the conventional lateral arm flap.