Comprehensive Reconstruction of a Complex Wrist Injury with Microsurgical Repair and Reverse Radial Forearm Flap

Abstract

We present the case of a 26-year-old male patient with a complex injury to his right wrist caused by a sharp object, which involved the skin, muscles, flexor tendons, radial artery, and median nerve. Following an initial, insufficient repair, functional deficits persisted, requiring specialized secondary reconstruction. During surgery, the team identified a “spaghetti wrist” injury and performed debridement, tendon repair using the Krackow technique, radial artery revascularization, and median nerve repair under optical magnification. The team closed the wound with a reverse radial flap and a partial-thickness skin graft, resulting in a favorable outcome and adequate functional recovery.