Fundamentals of Lateral Arm Free Flap

The lateral arm flap (LAF) was first described by Song. It is a thin and malleable flap, at the same time as it is very versatile; in fact, it can be harvested as a fasciocutaneous flap, but also as a fascial, musculocutaneous, and osteocutaneous flap; moreover, it can include tendon and nerve. Its harvest may be extended beyond the lateral epicondyle (eLAF). This flap is innervated by the inferior lateral brachial cutaneous nerve (LBCN) and the posterior antebrachial cutaneous nerve (PACN). Arterial supply originates from septocutaneous perforators of the posterior branch of the radial collateral artery (PRCA). Venous drainage is ensured by two concomitant veins accompanying the PRCA. Because of its versatility, the indications for the use of the LAF are many, from head and neck reconstructions to lower extremities. Typically, this flap is used for small and medium-sized hand and wrist defects.