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The radial free forearm flap

This flap consists of skin from the forearm with or without a segment of the underlying bone (the radius). It has been used to fill defects of the floor of the mouth, the posterior pharyngeal wall and particularly the combination of the floor and mouth and mandible, using the bone of the radius for this purpose. It is particularly applicable to defects of the anterior part of the mandible, which produce a catastrophic cosmetic deformity, known in the US as the ‘Andy Gump’ deformity after a celebrated, chinless, cartoon character. After connection of the main artery and vein supplying and draining the flap to local blood vessels, the bone may be secured with plates and screws.