Dealing with aberrant vessels in radial forearm flaps – Report of a case and review of literature

SummaryIntroductionAnomalies of the radial artery are uncommon. A brief tabulated review of the literature is presented.Case reportWe report a rare anomaly of the forearm vascular anatomy we encountered when elevating a radial forearm free flap. This is a previously unreported anatomical variation. The radial artery divided into medial and lateral branches (accompanied by their respective venae commitantes) about 1.5 cm below the bifurcation of the brachial artery. The skin paddle was predominantly supplied by the aberrant medial branch and was raised on this branch along with its venae commitantes up to the point of division.ConclusionThis case highlights the need for vigilance when raising free flaps and the techniques employed to avoid compromising both limb and skin paddle perfusion.