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a A 76-year-old patient underwent 80-Gy radiation treatment due to breast cancer after tumor ablation. A severe CRUCW was observed. b Intraoperative examination showed a necrotic partial clavicle and 2–4 ribs that were ablated with the parietal pleura. A filleted flap was made to repair the wounds using the dysfunctional ipsilateral upper limbs. c The filleted flap fitted the huge 35 cm X 25 cm wound. d Two years after the surgery, the radiation ulcer had healed completely
