Radial forearm skin with flexor carpi radialis muscle: a useful composite free flap.

Four patients were treated successfully with a simple modification of the standard radial forearm free flap. The flexor carpi radialis was harvested along with the radial artery vascular pedicle and forearm skin, producing a tennis racket-shaped flap. The entire flexor carpi radialis can be transferred based on radial artery perforators that enter the distal half of the muscle. The flexor carpi radialis can extend the versatility of the radial forearm free flap, principally by providing good-quality coverage of the vascular anastomoses.