Cömert ŞEN, Mehmet ERSİN, Sertaç YAKAL, Bora BAŞARAN
The Turkish Journal of Ear Nose and Throat - 2026;36(1):22-28
Objective: The radial forearm free flap (RFFF) is widely used in head and neck reconstruction, but potential long-term donor site functional morbidity remains debated. This study aimed to evaluate long-term forearm, hand, and wrist function utilising a novel dynamic biomechanical approach (isokinetic muscle strength measurement) alongside conventional static tests and assess their impact on quality of life (QoL) and activities of daily living (ADL). Materials and Methods: Twenty-one patients with a minimum six-months follow-up after RFFF harvest were evaluated. Biomechanical measurements were performed to evaluate forearm, wrist, and hand functions. Quality of life (QoL) and activities of daily living (ADL) were assessed using validated tools. Association between biomechanical parameters and QoL and ADL scores were investigated. Results: No statistically significant long-term decreases were observed in grip strength or wrist ROM on the operated side. While conventional static testing revealed significant decreases in tip-to-tip and palmar pinch strengths (p<0.05), isokinetic evaluation demonstrated that overall dynamic muscle strength was fundamentally preserved. Importantly, the objectively measured decreases in pinch strength and isolated extensor peak torque showed no statistically significant correlation with the QoL and ADL outcomes. Conclusion: Long-term QoL and the ability to perform daily activities do not deteriorate following the RFFF harvest. Although static biomechanical testing may identify minor, subclinical decreases in specific pinch strengths, the novel application of isokinetic testing confirms that the overall dynamic muscle strength and function of the forearm and wrist are preserved.
