An unusual anomaly of the radial artery with potential significance to the forearm free flap. Case report.

INTRODUCTION: The radial forearm free flap has become the favourite transplant for microsurgical repair of small-to-medium sized soft tissue defects of the oral cavity. This flap derives its blood supply from perforators of the radial artery. As the radial forearm flap gains ever more popularity, it is likely that anomalous forearm vascular patterns will be encountered by more surgeons. PURPOSE: In this paper, a rare anomaly found in a patient during flap elevation is described. This 63-year-old male had a squamous cell carcinoma of the floor of the mouth and a radial forearm free flap was harvested to repair the defect. During this procedure an aberrant duplication of the radial artery was found which could have significance in harvesting such a flap in other patients. CONCLUSION: There are anomalies of the radial artery that may jeopardize the vascular supply to the radial forearm free flap. Surgeons performing this flap must be aware of the most common variants of the vascular anatomy of the forearm.