Fig. 4.

a–b 53-year-old patient with a suspicious mass at the wrist level. The tumor displaces the ulnar palmar wrist structures (flexor tendons, ulnar nerve, ulnar artery, median nerve). c After incisional biopsy (synovial cell sarcoma G2), there was indication for radical resection and defect coverage. d–f In the radical tumor resection, all tendons, median nerve, and ulnar nerve could be preserved after epineural stripping. The tumor was resected with clear margins. g The defect was covered with a free lateral arm flap from the contralateral side (end-to-end-anastomosis of the flap artery to the ulnar artery), which had been resected for the purpose of oncological radicality. h–i Two years after the operation with adjuvant radiation therapy (60 Gray). No tumor recurrence and excellent function of the hand and wrist