Use of the distally-based radial forearm flap supplied by the dorsal carpal arch, or palmar carpal arch, or both, in mutilating injuries. Two case report.

The distally-based radial forearm flap is safe, easy, and versatile as a regional, one-stage procedure to reconstruct soft tissue defects of the hand. However, there is a general perception that the deep and superficial palmar arches have to be intact to raise a distally-based radial forearm flap. We successfully used two flaps supplied by the dorsal carpal arch, or the palmar carpal arch, or both, despite the fact that the deep and the superficial palmar arches were damaged in mutilating injuries.