Abstract
High trauma injuries of the forearm frequently present with complex bone and soft tissue defects. Early repair is required to retrieve the extremity and restore its function, As the advance of surgical repair and reconstruction technology, limbs damaged by high energy trauma that might have needed to be amputated in the past can now be saved by surgical reconstruction
 This is a case report of 36 year old man with left upper limb injury after high energy explosion trauma where a large soft tissue defect of the forearm with exposure of the vital structures and fracture of the ulna and radius and the fracture of radius and ulna were fixed by Elastic Nail to maintain their alignments and length, and put a cerclage on the fracture site of the radius to hold a fragment. The large soft tissue was reconstructed by a primary tendon and muscle repair, with vacuum assisted closure followed by split thickness skin graft. And at 6 Weaks physıotherapy was started wıth dynamıc hand splınt by slıgthly flexıng the fıngers
 The application of VAC as temporary coverage of large tissue defects in upper limbs supports wound conditioning and facilitates the definitive wound closure.
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