The free-fillet flap for reconstruction of the upper extremity

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wounds. However, in cases of complete extremity amputation, the transfer of pedicled flaps from the amputated part is not possible. In such instances, we have designed free-fillet flaps from the amputated limb to provide wound coverage when replantation of the amputated part was contraindicated. This technique allows immediate wound coverage and preservation of functional amputation stump length, without the morbidity of an additional donor site. We present three cases that demonstrate the utility of this technique as an additional reconstructive option in patients with unreplantable upper-extremity amputations.