DISCUSSION Outcome Assessment after Reconstruction of Complex Defects of the Forearm and Hand with Osteocutaneous Free

Dr. Kremer and colleagues have amassed animpressive series of upper extremity salvage procedures with osteocutaneous free flaps. Dur-ing a 12-year period, 15 patients with osseous and soft-tissue defects of the forearm and hand were treated with a variety of osteocutaneous free flaps. Blunt and penetrating trauma re-sulted in seven defects, while infection and tu-mor accounted for the other eight. Free flap selection was based on the magnitude of the bony defect, with the largest long bone defects reconstructed with the fibula free flap (n 8) and lesser bone defects with greater soft-tissue requirements reconstructed with free flaps from the scapula-parascapular axis (n 6). In a single case with a metacarpal defect, a lateral arm fla