A 26-year-old male who suffered a car accident with severe crushing of his left upper limb.
Plain radiography showed a diaphyseal fracture of the cubitus and radius.
The radial plate fixation column is severely injured, requiring excision of the scaphoid and tape, thus leaving a floating thumb.
The radio-dorsal face of the anomaly was exposed, as well as the base of the first metatarsal; in addition, there was radio-affective instability, and mental disorder.
In an initial care, a bone fixation device was applied to the first and second radio stabilization goal.
A week after this first intervention, the radio-dorsal face of the mental disorder and the base of the first metatarsal remained closed.
Given the significant lesions on the trajectory of the posterior interosseous artery and the dorsal interposed arch, observed by simple echo-doppler, a flap was placed in hse tapered posteriorly.
We also isolated a skin perforator of good caliber, 7cm proximal to the distal radioulnar joint, with a 22x5cm flap on the dorsal ulnar forearm based on the distal forearm.
The donor site was covered with partial skin free grafts.
