The development of varicosities within a free radial forearm flap used for distal-third tibial reconstruction

Reports of varicosities developing in free flaps are very rare. The presence of varicose veins in recipient sites influencing the development of varicosities in free flaps, though physiologically possible, has not been documented in literature. We encountered an unusual case of varicosities developing in a free radial forearm flap used in soft-tissue reconstruction of an open distal-third tibial fracture, which is presented here. This case report thus adds an important dimension to the assessment of a patient when planning a free flap procedure in a recipient area with pre-existing varicosities.