Objective: The objective of this study was to define and describe the anatomy of possible recipient arteries in the upper extremity that can be used for free tissue transplantation in a cadaveric model and to present clinical cases making use of these identified vessels. Methods: An anatomic study was carried out to define the possible recipient arteries in the upper extremity that can be used for free tissue transplantation on embalmed cadavers were dissected from the shoulder up to the wrist. The upper extremity was divided into two zones: Zone I was from the coracoid to the medial epicondyle of the humerus and Zone II was from the medial epicondyle up to the radial styloid of the wrist. Three clinical cases for Zone I and two clinical cases for Zone II are presented. Results: At least seven recipient arterial sites in Zone I and five recipient arterial sites in Zone II were suitable for microvascular anastomosis in cases of composite tissue transplantation in the upper extremity. In Zone I recipient sites, the thoraco-dorsal and posterior humeral circumflex arteries have the largest external diameter of around 4.3mm. The smallest external diameter was found to be the superior ulnar collateral artery at 2.0mm. In Zone II, the largest external diameter was found in the radial and ulnar arteries with an average diameter of 3.9mm. The smallest external diameter was the anterior interosseous artery at only 2mm. Conclusion: The upper extremity has many suitable recipient arterial sites for composite tissue transplantation. The knowledge regarding the location, vessel diameter and length will enable the microsurgeon to plan out the reconstructive procedure and know alternative recipient arterial sites when doing composite tissue transplantation of the upper extremity. Key words: recipient artery, composite tissue transplantation, upper extremity flaps
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