Background and objective.

The lateral arm flap is a coverage resource for the hand surgeon that has a wide variety of uses and applications due to its versatility and ease of collection with little morbidity from the donor site.

The aim of this research is to carry out dissections of the lateral arm flap in cadavers of the Colombian population to describe the main anatomical vari-ants and establish reference points for the development and improvement of current surgical techniques.

Methods.

Anatomical descriptive study of 10 upper limbs from fresh-frozen cadavers in which dissections were performed to document the main perforators of the lateral flap of the arm in the Colombian population. Distance measurements were taken from the perforators to the lateral epicondyle and ratios were obtained according to percentages of limb size. Likewise, the number of perforators in each quadrant and the diameter of the pedicles were quantified.

Results.

The results showed that in the lateral arm flap the order of appearance of the perforators from distal to proximal corresponds to 13, 19, 26 and 35% of the distance of the arm (between the epicondyle and the acromion); most of the perforators were found in the second quadrant, the second and fourth have less variation compared to the other perforators, the proximal pedicles have a larger diameter than the distal ones, the radial nerve was found at the exit the intermuscular septum on average 14.08 cm (+/- 0.83) from the epicondyle, this is a key reference for a careful dissection in order to avoid injury to it.

Conclusions.

In our study population, the lateral arm flap is highly versatile with a good number of perforators for its nutrition, which allows the surgeon multiple coverage options. The bone perforators of the distal humerus must be protected in the most distal portion to avoid complications such as bone necrosis, especially in children. An anterior approach to the pedicle axis allows them to be preserved, minimizing the risk of this potential complication. Our findings are consistent with previously published studies.

Level of evidence 5c Therapeutic

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