Forearm osteomusculocutaneous free filet flap for arm reconstruction after amputation as an alternative to shoulder disarticulation

• Published in: Annales de chirurgie plastique et esthétique Vol. 60; no. 2; pp. 148 - 152
• Main Authors: Gachie, E, Alet, J-M, Nguyen, P, Della Volpe, C, Casanova, D
• Format: Journal Article
• Language: French
• Published: France 01.04.2015
• Subjects: Amputation; Female; Free Tissue Flaps - transplantation; Humans; Median Nerve - surgery; Middle Aged; Neoplasms, Multiple Primary - pathology; Neoplasms, Multiple Primary - surgery; Neurilemmoma - pathology; Neurilemmoma - surgery; Neurofibromatosis 1 - complications; Peripheral Nervous System Neoplasms - pathology; Peripheral Nervous System Neoplasms - surgery; Sarcoma - pathology; Sarcoma - surgery; Shoulder disarticulation; Sarcoma; Neurofibromatose; Neurofibromatosis; Sarcome; Désarticulation d’épaule; Forearm free flap; Membre banque; Lambeau libre antébrachial radial; Free filet flap
• ISSN: 1768-319X
• DOI: 10.1016/j.anplas.2014.05.007

We report the case of a 55-year-old woman suffering from a type I neurofibromatosis (also known as Von Recklinghausen neurofibromatosis) who was diagnosed with a high-grade schwannosarcoma of the median nerve, between the upper third and the medium third of the arm, upon contact with the humerus, invading the humeral vessels. The oncologic treatment of this tumour consisted in the amputation of the arm through the surgical neck of the humerus. In order to create a laterothoracic claw, to bring a partial function of the upper limb back, we decided to realize a free fillet forearm flap. This composite flap was composed of the radius and the ulna, all the forearm muscles and the skin of the anterior side of the forearm. A humeroradial plate osteosynthesis was done and the flap was then harvested with the radial pedicle, and anastomosed to the axillar artery. This procedure gave our patient a functional stump, giving back the arm functionality, especially the claw movement.