Reconstruction of Complex Defects of the Forearm and Hand with Osteocutaneous Free Flaps

Complex defects of the forearm and hand often require microvascular reconstruction with osteocutaneous free flaps for limb salvage. The etiology of these complex defects can be major trauma about the forearm and hand, from severe infections including bony structures, or from radical resection of malignant tumors. The purpose of this presentation was to demonstrate a therapeutic approach for plastic reconstruction of complex defects about the forearm and hand for different conditions such as trauma, tumor, etc. Various cases were demonstrated and discussed, and an algorithm for sufficient treatment options, including the timing for flap coverage, was presented. The results from procedures at the BG-Trauma Center, Ludwigshafen, Germany clearly demonstrated that salvage of the forearm and hand with osteocutaneous free flaps is the treatment of choice over ablative surgery.