Soft-Tissue Reconstruction in Upper-Limb Trauma: Principles and the Radial Fasciocutaneous Flap

Traumatic injuries of the upper limb frequently involve complex soft-tissue defects with exposure of tendons, bones, joints, nerves, or vessels. Timely and stable coverage is essential to prevent infection, scarring, contracture, and functional impairment.

This webinar, presented by Lydia Helliwell, focuses on the principles of soft-tissue reconstruction in upper-limb trauma, with particular emphasis on the radial fasciocutaneous flap in its retrograde and antegrade variants. The session discusses patient assessment, wound preparation, flap selection, reconstructive planning, vascular anatomy, flap design, donor-site considerations, and postoperative rehabilitation.

Special attention is given to the reconstructive ladder and reconstructive elevator concepts, the importance of replacing “like with like,” indications for local, regional, pedicled, and free flaps, and the role of the Allen test before radial artery–based flap harvest. Clinical cases illustrate decision-making in dorsal hand defects, tendon exposure, carpal tunnel region reconstruction, and elbow soft-tissue coverage.

By connecting anatomical principles with practical surgical planning and postoperative functional recovery, this session provides clinicians with a structured approach to achieving stable coverage, preserving tendon gliding, minimizing complications, and restoring upper-limb function.

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SONA Global Virtual Education Conferences, created in partnership with the Harvard Global Orthopaedics Collaborative (HGOC), are the cornerstone of this educational programming—bringing together expert faculty and evidence-based insights to advance musculoskeletal care worldwide.

Speakers

• Lydia Helliwell, MD

Learning objectives

• Understand the key principles of soft-tissue reconstruction in traumatic upper-limb defects.
• Identify clinical indications for skin grafts, local flaps, regional flaps, pedicled flaps, and free tissue transfer.
• Explain the anatomical and vascular basis of the radial fasciocutaneous flap in retrograde and antegrade variants.
• Recognize technical considerations in flap planning, elevation, tunneling, venous outflow, and donor-site management.
• Apply reconstructive decision-making to clinical cases involving hand, wrist, and elbow soft-tissue defects.