Abstract
The novel approach of using the free Tensor Fascia Latae flap for functional reconstruction in patients with traumatic avulsion of the forearm musculotendinous extensor mechanism is previously unreported. The authors treated a 17-year old male whose left arm was severely injured during a roll-over motor vehicle collision. The patient suffered a significant degloving defect, avulsion of the forearm common extensor origin, humeral fracture, multiple tendon tears, as well as radial artery and radial nerve injuries. Following attempted radial artery revascularization, orthopedic stabilization and serial wound debridements, he was left with a large open wound and a dense wrist drop; both sequelae of the initial injury. Initial consultation to the plastic and reconstructive surgery team was made for soft tissue coverage of the exposed humerus. A free neurotized myo-fascio-cutaneous Tensor Fascia Latae flap was used to provide both soft tissue coverage as well as attempted return of function to the forearm extensors. This is the first case report using the innervated TFL for coverage and planned functional replacement of the wrist extensors within the forearm.