Posterior interosseous artery flap, fasciosubcutaneous pedicle technique: a study of 25 cases

Anatomical basis of a proximal fasciocutaneous extension of the distal-based posterior interosseous flap that allows exclusion of the proximal posterior interosseous artery

“…However, the technical demands of the pedicle dissection, along with the risks of ischemic necrosis and venous congestion, are considered to be major drawbacks of the flap. 4,8,13 Furthermore, dissecting the neurovascular bundle formed by the PIA, venae comitantes, and PIN could injure the PIN, 8,19,20 and dissecting the neurovascular bundle takes precious tourniquet time. A more simple and convenient approach is required for flap harvest when practicable.…”

“…13,30 The operative technique was modified by Vinita Puri et al 13 in 2007. They preoperatively ascertained with Doppler ultrasonography that the anastomosis between the AIA and PIA was raised straightway, which saved precious tourniquet time.…”

“…4e19 The disadvantages of this technique include unreliable vascular anatomy as a result of damage to the small vessels or anatomical variations 3,5,15,20 and tedious pedicle dissection. 13 Additionally, because the PIA is proximally accompanied by the posterior interosseous nerve (PIN) in the form of neurovascular bundles, the hazard of cutting the PIN branches increases during pedicle dissection. 8,19,20 Sporadic reports have demonstrated that PIA 21e23 or PIA perforator 24,25 free flaps are clinically useful.…”

The Reverse Posterior Interosseous Artery Flap: Technical Considerations in Raising an Easier and More Reliable Flap

“…However, technically demanding dissection of the pedicle along with risks of ischemic flap necrosis and venous congestion are said to be major drawbacks of this flap. 5 Subsequently, technical modifications have been described to overcome these problems. 2,5,6 We present a Among the posttraumatic injuries, motor vehicle accidents were the most common cause, followed by industrial accidents.…”

“…5 Subsequently, technical modifications have been described to overcome these problems. 2,5,6 We present a Among the posttraumatic injuries, motor vehicle accidents were the most common cause, followed by industrial accidents. The indications for this flap reconstruction were defects in the dorsum of hand, palm, first webspace, and the radial or ulnar half of the hand.…”