The radial forearm flap is a very useful and versatile flap with a long vascular pedicle and a thin, pliable skin. It's used in reconstruction of the mutilated hand as a reverse pedicled flap. The dominant pedicle is the radial artery, with venous outflow through the dual system of the venae comitantes and cephalic vein. Sensory innervation may be derived from the medial and lateral antebrachial cutaneous nerves. The radial forearm flap offers the advantage of a large area of donor tissue from the involved extremity with the potential for inclusion of bone, nerve, and tendon grafts. Sacrifice of the radial artery has not been associated with significant patient symptoms However, the donor defect can be troublesome, frequently requiring skin grafting directly over the paratenon of the flexor tendons, producing an undesirable donor site appearance

Inclusion Criteria:

• patients aging 5 to 80 years.
• Soft Tissue defects following MCA injuries.
• Defect size less than 30 cm

Exclusion Criteria:

• Peripheral vascular disease
• Underling bone osteomyelitis
• Unhealthy skin of volatile aspect of donor forearm
• Defect more than 30 cm
• Ulnar artery previous ligated