Posterior Interosseous Island Forearm Flap

1988 ◽  
Vol 13 (2) ◽  
pp. 130-135
Author(s):  
E. A. ZANCOLLI ◽  
C. ANGRIGIANI
Keyword(s):  
Distal Part ◽  
Vascular Anatomy ◽  
Island Flap ◽  
Forearm Flap ◽  
Posterior Interosseous Artery ◽  
Skin Defects ◽  
Dorsal Aspect ◽  
Donor Area ◽  
Interosseous Artery ◽  
Web Space

The skin of the dorsal aspect of the forearm is supplied by several cutaneous branches of the posterior interosseous artery. This vascular anatomy permits the surgeon to obtain an island flap of the dorsal forearm based on the distal anastomosis between the two interosseous arteries at the distal part of the interosseous space. This flap can reliably be transferred to different skin defects of the hand such as those created by correction of an adduction contracture of the first web space, or on the back or front of the wrist level. Its principal advantages are that it is a thin flap with excellent circulation and that it is possible to close the donor area primarily provided the island flap is not wider than 3 to 4cm. The procedure has been employed in 25 patients with satisfactory results.

Le lambeau interosseux postérieur à pédicule externe

2002 ◽  
Vol 10 (4) ◽  
pp. 159-162
Author(s):  
Am Belmahi ◽  
N Gharib ◽  
A Abbassi
Keyword(s):  
Distal Part ◽  
Dorsal Side ◽  
Skin Defects ◽  
Anterior Interosseous Artery ◽  
Donor Area ◽  
Interosseous Artery ◽  
Web Space ◽  
Electrical Burns ◽  
Large Skin ◽  
Skin Coverage

The posterior interosseous flap with external pedicle is characterized by the inclusion of the quasi-totality of the posterior forearm fascia to the septum of the posterior interosseous vessels, the flap reaching the defect without tunnelization of this pedicle. The coverage of distal defects in the hand without dangerous dissection of the distal part of the interosseous posterior pedicle, the coverage of large skin defects without sacrificing more skin in the donor area by simply grafting this pedicle, and the possibility of secure immediate defatting of this flap are the main advantages of this technique. From February 1997 to March 2001, there were 12 cases of PIO flaps with external pedicle in patients aged 16 to 65 years. This skin coverage involved the first web space in eight cases, the first and second web spaces in two cases, and the dorsal side of the metacarpophalangeal joints in two other cases. These skin defects were due to severe retractile sequellae of thermic and electrical burns, and their sizes varied from 5×7 cm to 6×12 cm. In all cases, the dissection of the posterior interosseous pedicle stopped 2 cm before its anastomosis with the anterior interosseous artery. In three cases of obese patients, immediate defatting was peformed without any complications. All patients benefitted from an orthesis that kept the wrist in extenstion for three weeks to protect the pedicle, which was sectionned at this date. No complications were reported.

Reverse Posterior Interosseous Flap Based on an Exteriorized Pedicle to Cover Digital Skin Defects

2000 ◽  
Vol 25 (3) ◽  
pp. 296-299 ◽  
Author(s):  
F. BRUNELLI ◽  
H. GIELE ◽  
R. PERROTTA
Keyword(s):  
Local Anaesthesia ◽  
Island Flap ◽  
Vascular Pedicle ◽  
Two Stage ◽  
Pedicle Flap ◽  
Skin Defects ◽  
Axis Of Rotation ◽  
Dorsal Aspect ◽  
Web Space

The posterior interosseous arterial flap is limited by its short vascular pedicle and proximal axis of rotation to the coverage of defects on the dorsal aspect of the hand and the first web space. The authors present the results of three cases in which these limits were surpassed by extending the wrist and exteriorizing the vascular pedicle, thus causing it to bowstring across the angle created by the extended wrist. When flap inset is complete the vascular pedicle is excised under local anaesthesia. This technique is an amalgamation of an island flap and a traditional pedicle flap and, as such, it is a two-stage procedure.

Anatomical Basis of Dorsal Forearm Flap

1988 ◽  
Vol 13 (4) ◽  
pp. 435-439
Author(s):  
P. BAYON ◽  
R. W. H. PHO
Keyword(s):  
Upper Limbs ◽  
Forearm Flap ◽  
Posterior Interosseous Artery ◽  
Anatomical Basis ◽  
Skin Loss ◽  
Cutaneous Flap ◽  
Interosseous Artery ◽  
Vascular Contribution

Injection studies on 35 upper limbs with neoprene latex were carried out and the limbs carefully dissected to observe the vascular contribution of the posterior interosseous branches of the dorsal forearm, the transverse anastomosis between anterior and posterior interosseous vessels and the calibre of the vessel. The findings indicated that a fascia-cutaneous flap based on septocutaneous branches of the posterior interosseous artery can be raised as a reversed forearm for resurfacing after skin loss in the hand.

scholarly journals Free Posterior Interosseous Artery Flap for Treatment of First Web Space Contracture: Methods of Venous Anastomosis

2019 ◽  
Vol 24 (4) ◽  
pp. 408
Author(s):  
Masao Fujiwara ◽  
Yuki Matsushita ◽  
Yoshikane Maeba ◽  
Ayano Suzuki ◽  
Hidekazu Fukamizu ◽  
...  
Keyword(s):  
Venous Anastomosis ◽  
Posterior Interosseous Artery ◽  
Interosseous Artery ◽  
Web Space ◽  
Posterior Interosseous Artery Flap

Versatility of the Posterior Interosseous Artery Flap: Emphasis on Powering Up the Toe Transfer

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
GiJun Lee ◽  
BumSik Kim ◽  
Neunghan Jeon ◽  
JungSoo Yoon ◽  
Ki Yong Hong ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Reverse Flow ◽  
Donor Site ◽  
Congenital Defects ◽  
Soft Tissue Coverage ◽  
Posterior Interosseous Artery ◽  
Arterial Inflow ◽  
Pedicle Length ◽  
Interosseous Artery

Background: Reverse-flow posterior interosseous artery (rPIA) flap is an excellent tool for restoration of defects in the hand and upper extremity, sparing the main arteries to the hand. Its reliability has been well established. Materials and Methods: Fifty-one cases of rPIA flap involving 49 patients were retrospectively reviewed. The inclusion criteria were age, sex, etiology, size and location of the defect, flap size, number of perforators included, pedicle length, flap inset, donor site coverage, complications, and ancillary procedures. Results: This study included 44 men and 5 women, ranging in age between 10 and 73 years. The subjects had soft tissue defects of the hand and upper extremity mainly due to traumatic injuries, including scar contractures of the first web space in 18 cases, thumb amputations in 6 cases, and congenital defects in 1 case. Among the 51 rPIA flap elevations, 3 cases involved flap failure due to the absence of proper pedicle. A fasciocutaneous pattern was observed in 45 cases and a myocutaneous pattern in 3 cases. In 5 cases of unplantable thumb amputations, the rPIA flap was performed for arterial inflow to the secondary toe-to-thumb transfer. Venous congestion of varying degrees was noted in 7 cases involving partial necrosis in 2 cases. During the mean 17 months of follow-up, patients were generally satisfied with the final outcomes. Conclusion: The rPIA flap can be used not only for soft tissue coverage of the hand and upper extremity but also as a recipient arterial pedicle for a secondary toe-to thumb transfer.

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