Reversed Posterior Interosseous Flap: Safe and Easy Method for Hand Reconstruction

Abstract

Complex hand trauma presents multifaceted problems for the surgeon. Soft tissue defects of the upper extremity must be carefully assessed to determine the most appropriate method of coverage of hand. In this article, the reversed posterior interosseous flap was used for coverage of the hand. The injured areas include: dorsum of the hand (10 cases), the wrist (3 cases) and the dorsal thumb (2 cases). All flaps survived completely and none exhibited venous compromise. All donor sites were skin grafted. The reversed posterior interosseous flap is a versatile option for coverage of moderate sized defects of the hand and is specifically indicated for coverage of injuries of the wrist, dorsal hand and dorsal thumb.

Keywords

Hand injuries - Reversed posterior interosseous flap - Dorsum of hand - Wrist and thumb

Electronic supplementary material The online version of this article (doi:10.1007/s12593-011-0042-y) contains supplementary material, which is available to authorized users.

• References

• 1 Jeng S-F, Wei F-C. The distally based forearm island flap in hand reconstruction. Plast Reconstr Surg 1998; 102: 400
• 2 Zancolli EA, Angrigiani C. Posterior interosseous island forearm flap. J Hand Surg (Br) 1988; 13: 130
• 3 Landi A, Luchetti R, Soragni O, De Santis G, Sacchetti GL. The distally based posterior interosseous island flap for the coverage of skin loss of the hand. Ann Plast Surg 1991; 27: 527-536
• 4 Balakrishnan G, Kumar BS, Hussain SA. Reverse-flow posterior interosseous artery flap revisited. Plast Reconstr Surg 2003; 111 ((7)) 2364-9
• 5 Iwuagwu FC, Wilson D, Bailie F. The use of skin grafts in postburn contracture release: a 10-year review. Plast Reconstr Surg 1999; 103 ((4)) 1198-204
• 6 Uygur F, Duman H, Celikoz B. Use of free anterolateral thigh perforator flap in the treatment of chronic postburn palmar contractures. Burns 2008; 34 ((2)) 275-80
• 7 Lu LJ, Wang SF. The posterior interosseous flap: a report of 6 cases. The Second Symposium of the Chinese Association of Hand Surgery. 1986. Tsingtao City: pp 187-191
• 8 Penteado CV, Masquelet AC, Chevrel JP. The anatomic basis of the fasciocutaneous flap of the posterior interosseous artery. Surg Radiol Anat 1986; 8: 209-215
• 9 Richard BM. Distally based posterior interosseous island flap. Br J Plast Surg 1995; 48: 258
• 10 Mazzer N, Barbieri CH, Cortez M. The posterior interosseous forearm island flap for skin defects in the hand and elbow. A prospective study of 51 cases. J Hand Surg [Br] 1996; 21: 237-243
• 11 Giunta R, Lukas B. Impossible harvest of the posterior interosseous artery flap: a report of an individualised salvage procedure. Br J Plast Surg 1998; 51: 642-645
• 12 Costa H, Comba S, Martins A et al Further experience with the posterior interosseous flap. Br J Plast Surg 1991; 44: 449-455
• 13 Muhlbauer W, Herndl E, Stock W. The forearm flap. Plast Reconstr Surg 1982; 70: 336-342
• 14 Song R, Gao Y, Song Y et al The forearm flap. Clin Plast Surg 1982; 9: 21-26
• 15 Angrigiani C, Grilli D, Dominikow D et al Posterior interosseous reverse forearm flap: experience with 80 consecutive cases. Plast Reconstr Surg 1993; 92: 285-293
• 16 Shibata M, Iwabuchi Y, Kubota S et al Comparison of free and reversed pedicled posterior interosseous flap. Plast Reconstr Surg 1997; 99: 791-802
• 17 Chen HC, Cheng MH, Schneeberger AG et al Posterior interosseous flap and its variations for coverage of wounds. J Trauma 1998; 45: 570-574
• 18 Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K. Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases. Plast Reconstr Surg 1998; 102: 1517
• 19 Shieh SJ, Chiu HY, Yu JC et al Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation. Plast Reconstr Surg 2000; 105: 2349
• 20 Luo S, Raffoul W, Luo J et al Anterolateral thigh flap: a review of 168 cases. Microsurgery 1999; 19: 232
• 21 Yilmaz M, Karatas O, Barutcu A. The distally based superficial sural artery island flap: clinical experiences and modification. Plast Reconstr Surg 1998; 102: 2358-2367