Integrated tendon repair and staged skin grafting for a severe forearm degloving injury: A case report from a low-resource setting.
Garuun Mohamed Abdikadir, Moise Mvuye Manishimwe, Mahmoud Bakheet Abdulrahman et al.
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Case in brief
A 21-year-old right-handed man presented two hours after a road traffic collision with extensive degloving of the right forearm, wrist, and dorsal thumb. Examination and surgery showed exposed underlying structures and ruptured flexor digitorum superficialis tendon slips; radiographs also identified a distal humerus fracture. He underwent urgent irrigation and debridement, primary tendon repair, and partial wound closure, followed by split-thickness skin grafting of the residual dorsal thumb defect. The fracture was immobilized. At six weeks, the wounds and graft had healed satisfactorily, thumb and finger movement was preserved, and he had regained useful hand function after physiotherapy.
What made this case unusual
The case illustrates staged tendon repair and skin graft coverage for extensive upper-limb degloving in a low-resource setting where microsurgical reconstruction was unavailable.
Diagnostic / clinical pearl
In selected degloving injuries, operative exploration can identify tendon disruption beneath exposed structures; early debridement and tendon repair with staged graft coverage may support useful early function when microsurgical options are unavailable.