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Figure 4. Functional upper limb reconstruction with a combination of free functioning muscle transfer and nerve transfer for a right forearm defect in a 68-year-old female, which involved resection of 15 cm of ulnar nerve and common flexor mass. A: free functioning gracillis myocutaneous flap in position with the proximal muscle inset into proximal flexor digitorum profundus stump; B: close up image demonstrating the anterior interosseous nerve to ulnar motor and lateral cutaneous nerve of the forearm to ulnar sensory nerve transfers; C: result at one year showing excellent flap contour, no claw-hand deformity; D: good flexion of digits demonstrating reinnervation of the gracillis muscle