Recipient Vessels: Ulna Reconstruction

Anatomical and functional integrity of the ulna is mandatory for functioning upper extremity. Free fibula flap can be used in reconstruction of various defects of the ulna. The forearm has an abundance of recipient vessels available for both arterial inflow and venous outflow. However, decision-making in selection of the particular vessel and anastomosis configuration requires careful preoperative planning. The presence of anatomic variations in palmar arches, ulnar and radial arteries, and their dominancy on hand circulation are important factors. End-to-side anastomosis of ulnar and radial arteries are end-to-end anastomosis to their large side branches are available options in microsurgical transfers to the forearm. Superficial and deep venous systems of the forearm both provide reliable venous outflow for fibula flap. This chapter focuses on selection of recipient vessels in treatment of ulnar defects with free fibula flap.