Lower arm
Treatments of postoperative problems affecting the lower arm include
- The usual maxillofacial reasons for surgery on the lower arm will be harvesting of a radial forearm free flap (or much less often an ulnar forearm flap). Altered appearance and minor sensation disturbances are the major issues. Ischaemia of the thumb or fracture of the radius are very rare.
- Scars. The lower arm is visible in many cultures and there will be visible scars. Treatment ranges from scar modification using compression, massage, silicone gels and sheets to formal scar revision.
- If a radial forearm flap has been raised the radial artery is removed as part of the flap. Critical ischaemia is very rare but if this does occur, the radial artery is reconstructed with a vein of PTFE (polytetrafluoroethylene, a synthetic polymer) graft.
- Altered sensation . The superficial branch of the radial nerve is manipulated during the dissection to raise the radial flap. It is quite common to have some altered sensation over the area of the thumb base (thenar eminence). While irritating, this can usually be overcome with counter-irritation (rubbing gently or with a toothbrush) and time.
- Grip strength. Unless a fracture of the radius has occurred (and if a part of the radius has been harvested to create an osseocutaneous flap, the radius should be prophylactically plated) grip strength is returned to normal with simple physiotherapy exercises of the kind used in improving the symptoms of arthritis of the hand.