Radical forearm flap with vascularized tendons for hand reconstruction

We treated six patients with soft-tissue defects involving the skin and extensor or flexor tendons using a cutaneotendinous radial forearm flap. There were five male patients and one female patient. Their ages at operation ranged from 22 to 65 years (mean 50 years). In one patient, the flexor pollicis longus tendon was reconstructed with a palmaris longus tendon graft. Four patients each had two extensor tendons reconstructed. This was performed either with the palmaris longus tendon folded in the center (n = 2) or with the palmaris longus and flexor carpi radialis tendons (n = 2). In the remaining patient, three extensor tendons were reconstructed with the palmaris longus and flexor carpi radialis tendons. All the flaps survived. Recovery of motor function has been satisfactory in all but one patient.