The osteocutaneous upper arm flap for mandibular reconstruction.

The authors present the osteocutaneous upper arm flap as useful in segmental microsurgical mandibular reconstructions. This flap presents several advantages: easy and rapid dissection; a long and reliable pedicle; excellent segmental blood supply to the bone, allowing multiple osteotomies; remarkable mobility of the skin paddle relating to the underlying bone; and minimal donor-site morbidity. Among its few disadvantages are that the bone is predominantly cortical, and the bone shaft cannot exceed 11 x 2 cm. Nevertheless, this flap is an excellent alternative to conventional procedures, when a segmental reconstruction, requiring short bone segments and skin, is required. Eight consecutive clinical cases have been successfully treated and are reported.