Abstract
Background The radial forearm flap (RFF) is a versatile flap that can be used for soft-tissue
coverage or as a source of vascularized bone during reconstruction. A problem that
can arise after RFF harvest is tendon exposure in the donor site, which may lead to
tendon injury and restriction of the hand and wrist’s range of motion. Many different
methods for providing adequate tendon coverage in the donor site after RFF harvest
have been reported. We present a novel technique for coverage of exposed tendon in
the volar forearm with an epimysial transposition flap and a split-thickness skin
graft (STSG).
Methods Retrospective review of two cases: one salvage case with exposed tendon after harvesting
an RFF and another with exposed volar forearm tendon after traumatic injuries. Variables
of interest were post-operative STSG integration and hand/wrist range of motion.
Results Both cases demonstrated 100% graft take at 5-week follow-up. No decrease in hand/wrist
range of motion in the patient that could undergo testing.
Conclusion We introduce two cases for coverage of exposed flexor tendon in the volar forearm
with an epimysial transposition flap. This can be used as a salvage operation for
coverage of exposed tendon or as an acute method of tendon coverage prior to skin
grafting. In both cases, the skin graft had excellent incorporation.
Keywords
radial forearm flap - epimysial transposition flap - upper extremity reconstruction
