Aberrant branch of the radial artery encountered during elevation of the radial forearm free flap.

Although the radial arterial system is fairly consistent in structure, rare anomalies have been encountered. During the elevation of a radial forearm free flap for floor of mouth reconstruction, the authors have encountered an accessory branch of the radial artery arising from the main radial artery at the level of the mid forearm, extending laterally over the brachioradialis muscle, and descending into the dorsal wrist in the subcutaneous plane. This artery, named as the superficial radial artery, is a very rare vascular anomaly of the radial arterial system in the forearm. The reconstructive surgery literature is relatively silent about this particular variant. Knowledge of possible anatomic anomalies and careful identification of vessels are important to prevent damage to the arterial system and enable optimal flap harvest.