Lateral arm free flap transfer to cover traumatic hand injuries

The advantages of free flaps over distant pedicled flaps in hand reconstruction are well documented. They often require only a single operation, do not depend on local conditions of the wound and permit early physiotherapy. The lateral arm free flap is essentially suitable for reconstruction of the hand. It is thin, potentially sensate, and gives nearly perfect skin color and texture match. An additional technical advantage is the possibility of elevating the lateral arm free flap with tourniquet control at the same surgical field as the recipient site. We describe 3 cases of traumatic damage to skin and soft tissue of the hand, in which reconstruction was by both elective and emergency lateral arm, free flap transfer. They demonstrate the merits of this method of reconstruction.