We report two cases with massive skin defects of the forearm treated with a free tensor fascia lata flap. Case 1 was a 31-year-old male with contracture of the elbow, wrist, and thumb after a free skin graft for a counter incision due to compartment syndrome. The free skin graft causing contracture was converted to a free tensor fascia lata flap with a size of 40 × 10 cm. The flap survived well and the contracture was released. Case 2 was a 55-year-old male with open fractures of the elbow and wrist. The skin on the volar side of the forearm became totally necrotic. A tensor fascia lata flap ( size 35 × 14 cm ) was placed after thorough debridement of the necrotic tissue and once the distal one-sixth became partially necrotic. He returned to daily activity after a necrotomy and secondary suture. Although we have to pay attention to distal partial necrosis if we use a full length flap, the tensor fascia lata free flap was useful for massive skin defects on the forearm because most of the flap survived without infection.
