Arch Plast Surg.  2018 Sep;45(5):479-483. 10.5999/aps.2017.01802.

Simultaneous reconstruction of the forearm extensor compartment tendon, soft tissue, and skin

• Oh J
• Ahn HC
• Lee KH

• KMID: 2422146
• DOI: http://doi.org/10.5999/aps.2017.01802

Abstract

Malignant peripheral nerve sheath tumor (MPNST) is a very rare type of sarcoma, with an incidence of 0.001%. MPNST has a 5-year survival rate near 80%, so successful reconstruction techniques are important to ensure the patient's quality of life. Sarcoma of the forearm is known for its poor prognosis, which leads to wider excision, making reconstruction even more challenging due to the unique anatomical structure and delicate function of the forearm. A 44-year-old male presented with a large mass that had two aspects, measuring 9×6 cm and 7×5 cm, on the dorsal aspect of the right forearm. The extensor compartment muscles (EDM, EDC, EIP, EPB, EPL, ECRB, ECRL, APL) and invaded radius were resected with the mass. Tendon transfer of the entire extensor compartment with skin defect coverage using a 24×8 cm anterolateral thigh (ALT) perforator free flap was performed. The patient was discharged after 18 days without wound complications, and has not complained of discomfort during supination, pronation, or wrist extension/flexion through 3 years of follow-up. To our knowledge, this is the first report of successful reconstruction of the entire forearm extensor compartment with ALT free flap coverage after resection of MPNST.

Keyword

Forearm; Neoplasms; Surgical flaps

MeSH Terms

Adult
Follow-Up Studies
Forearm*
Free Tissue Flaps
Humans
Incidence
Male
Muscles
Neurilemmoma
Peripheral Nerves
Prognosis
Pronation
Quality of Life
Radius
Sarcoma
Skin*
Supination
Surgical Flaps
Survival Rate
Tendon Transfer
Tendons*
Thigh
Wounds and Injuries
Wrist