[Post-primary functional soft tissue coverage after extensive muscle-/soft tissue loss of the upper extremity]

Two cases of severe contusion/avulsion injuries of the upper extremity with involvement of the neuro-vascular structures and extensive muscle necrosis after post-ischemic syndrome (PIS) are demonstrated. The concept of early post-primary soft tissue coverage and the opportunity of a simultaneous "functional" soft-tissue replacement with pedicled neuro-vascular myocutaneous island flaps is elucidated.