Introduction: The radial forearm osseo-cutaneous free flap can be an excellent reconstructive modality for facial defects. This flap is not usually used because of potential morbidities.

The aim of this study to present our results of experimental radio-anatomical study on the radius vascularization and clinical applications.

Materials and methods: Radio-anatomical study : Three frozen forearms were studied. The vessels were filled with gelatin and red lead oxide. A micro-CT scan (Nano-SPECT-CT, Bioscan ^® ) was performed first. Then, a composite forearm flap was harvested. Finally a second micro-CT scan was performed.

Clinical study : A retrospective study was performed in patients underwent a facial reconstruction with osseo-cutaneous radial forearm free flap. The donor site was reconstructed using titanium mesh, bone substitute and artificial dermis.

Experimental and clinical data were analyzed.

Results: Radio-anatomical study : An average of 34 collateral branches of the radial artery was founded. The maximum of radial bone’s length disposable was 16 cm. There was a mean of 4 diaphyseal arteries per flap.

Clinical study : Five patients had this type of reconstruction in mean time of 75 min. The mean age was 72 years. All patients had severe arteritis of lower limbs. Maximal cutaneous paddle was 20 cm × 10 cm and maximum bony resection was 13 cm. No flap failure or fracture was noted. A CT-scan showed good osseo-integration of bone substitute.

Discussion: The radial forearm osseo-cutaneous free flap can be an alternative in facial composite defects.

Conflict of interest : None declared.