Flail Arm Reconstruction After Failed Nerve Transfers: A Case Report

A 53-year-old, right-hand-dominant gentleman suffered a traumatic right scapulothoracic dissociation with severe soft tissue damage and complete right arm paralysis following a high-speed all-terrain vehicle accident. Subsequent burns led to digital amputations. He underwent elbow disarticulation with humeral shortening osteotomy, glenohumeral arthrodesis, and a vascularized radial osteocutaneous flap for clavicular reconstruction. Postoperatively, he achieved stable limb positioning and functional improvement with a prosthesis.

This case underscores the importance of a multidisciplinary approach and innovative surgical techniques in managing complex upper extremity injuries. Collaborative planning and the resourceful use of "spare parts" were pivotal in achieving a favorable outcome.