Management of the radial composite donor site: an orthopaedic opinion

• Published in: British journal of oral & maxillofacial surgery Vol. 37; no. 3; pp. 213 - 216
• Main Authors: Sidebottom, A.J., Allen, P.E., Hayton, M., Vaughan, E.D., Brown, J.S.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Londonc Elsevier Ltd 01.06.1999; Elsevier
• Subjects: Biological and medical sciences; Bone Transplantation - methods; Dentistry; Diseases of the osteoarticular system. Orthopedic treatment; Female; Humans; Male; Medical sciences; Orthopedic surgery; Orthopedics - statistics & numerical data; Postoperative Complications - prevention & control; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Radius - surgery; Radius Fractures - prevention & control; Skin Transplantation - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps; Surveys and Questionnaires; United Kingdom; Human; Radius; Osteoplastic flap; Donor site; Orthopedic treatment; Diseases of the osteoarticular system; Fracture; Trauma; Prevention; Composite flap; Treatment; Surgery; Upper limb
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1054/bjom.1998.0019

Maxillofacial and plastic surgeons have reported on the management of radial composite flap donor sites, but little reference is made to orthopaedic advice. Orthopaedic surgeons manage forearm injuries more often than other specialties and we thought that an orthopaedic consensus was long overdue. The composite radial donor site subsequently fractures in up to 43% of cases. There is no agreement on the optimal management of these difficult injuries and the patient is often referred for orthopaedic advice. Options include plaster-cast immobilization, internal fixation with either a plate or intramedullary nail, and external fixation. Bone grafting may also be required. A postal questionnaire, using two case histories including radiographs, was sent to 100 consultant orthopaedic surgeons in the UK asking how they would manage the donor site primarily and how they would manage a fracture at this site. Fifty-nine adequate replies were received. Generally, six weeks of immobilization in a plaster of Paris (POP) cast was considered sufficient for the initial management of the donor site. In the event of a fracture, internal fixation with a dynamic compression plate with or without a cancellous bone graft was the most common choice.