A novel technique for the prophylactic plating of the osteocutaneous radial forearm flap donor site.

The osteocutaneous radial forearm free flap (ORFFF) provides a suitable composite construct for reconstruction of head and neck defects. Initial acceptance of the ORFFF during the 1980s waned significantly as long-term outcome studies demonstrated a high incidence of donor-site fractures associated with harvesting a segment of the cortical radius. Biomechanical and clinical studies have demonstrated a significant improvement in the mechanical strength of ostectomized long bones after prophylactic plating. Our case report identifies a novel technique for rigid fixation using a low-contact, locking-screw plating system (LCP, Synthes USA). The system provides a fixed-angle construct using a locking-screw system that provides appropriate axial load transfer using unicortical screw fixation.