Skip to main content
SpringerLink
Log in

Role of Interosseous Recurrent Artery Perforators in the Posterior Interosseous Artery Flap

  • Original Article
  • Published:
Journal of Hand and Microsurgery

Abstract

The Posterior Interosseous Artery flap is a fasciocutaneous flap based on the Posterior Interosseous artery which lies invested by the fascial septum between the Extensor carpi ulnaris and Extensor Digiti Minimi where it gives off septocutaneous branches that spread out on the deep fascia to form longitudinal fascial arcades as well as supply the deep extensors. The conventional flap based on these perforators is restricted to the middle-thirds of the dorsum of forearm. Preservation of the perforators from the Interosseous Recurrent Artery by proximal ligation of the Interosseous Recurrent Artery and by protecting the index septum prolongation carrying the perforators of IRA can help us to recruit larger tissue in the flap. A total of 20 clinical cases and 10 cadaveric dissections were done to objectively define this technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Rohan P, James C (2006) Reconstruction of hand soft-tissue defects: alternatives to the radial forearm fasciocutaneous. Flap J Hand Surgery 31(5):847–85

    Article  Google Scholar 

  2. Acharya AM, Bhat AK, Bhaskaran K, The Reverse Posterior Interosseous Flap (2012) Technical considerations in raising an easier and more reliable flap. JHS 37(3):575–582

    CAS  Google Scholar 

  3. Horácio C, Cristina C, António C et al (2001) The posterior interosseous flap: a review of 81 clinical cases and100 anatomical dissections — assessment of itsindications in reconstruction of hand defects. Br J Plastic Surgery 54(1):28–33

    Article  Google Scholar 

  4. Bayon P, Pho RWH (1988) Anatomical basis of forearm flap based on posterior interosseous vessels. J Hand Surgery 13:435

    Article  CAS  Google Scholar 

  5. Brunelli F, Valenti P (2001) The Posterior Interosseous reverse flap: experience with 113 flaps. Ann Plast Surg 47:25

    Article  CAS  PubMed  Google Scholar 

  6. Zancolli EA, Angrigiani C (1988) Posterior interosseous island forearm flap. J Hand Surgery Br 13(2):130–135

    Article  CAS  Google Scholar 

  7. Taylor GI (1990) The doppler probe for planning flaps: anatomical study and its clinical applications. Br J Plast Surg 43:1–16

    Article  CAS  PubMed  Google Scholar 

  8. Steven L Moran, William Patrick Cooney (2009) Soft tissue surgery, Page 192 Google books result

  9. Martin D, Legaillard P, Bakhach J, Hu W, Baudet J (1994) Reverse flow YV pedicle extension:a method of doubling the arc of rotation of a flap under certain conditions. Ann Chir Plast Esthet 39(4):403–14

    CAS  PubMed  Google Scholar 

  10. Hallock GG (1992) Editor fasciocutaneous flaps; Ist edition. Chap 7:81

    Google Scholar 

  11. Penteado CV, Masquelet AC, Cheveral JP et al (1986) Anatomical basis of the fasciocutaneous flap of the posterior interossous artery. Surg Radiol Anat 8:209

    Article  CAS  PubMed  Google Scholar 

  12. Inoue Y, Taylor GI (1996) The angiosomes of the forearm: anatomic study and clinical implications. Plast Reconstr Surg 98(2):195–210

    Article  CAS  PubMed  Google Scholar 

  13. Kanellakos GW et al (2003) Cutaneous vasculature of the forearm. Ann Plast Surg 50(4):387–92

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Madras Medical College, Chennai, 600003, Tamilnadu, India

    Rohini Prasad & T. M. Balakrishnan

Authors
  1. Rohini Prasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. M. Balakrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rohini Prasad.

Appendix

Appendix

Site of entry of PIA in the posterior compartment

 

14–15CM

15–16CM

16–17CM

CADAVERIC

nil

3

7

CLINICAL

2

2

16

Number of perforators from the PIA

no. of perf

1

2

3

4

5

CADAVERIC

nil

1

4

5

nil

CLINICAL

nil

nil

3

15

2

Distance of the distal most perforator from the ulnar styloid process

 

7.5–8.5CM

8.5–9.5CM

9.5–10.5CM

10.5–11.5CM

CADAVERIC

2

6

2

nil

CLINICAL

7

9

3

1

Site of anastomosis between PIA and AIA from ulnar styloid process

 

2.0–2.5

2.5–3.0 cm

3.5–4.5CM

CADAVERIC

9

1

nil

CLINICAL

11

7

2

Origin of IRA

site

oblique cord

APL/Sup

cadaveric

7

3

clinical

11

9

Plane of IRA

PLANE OF IRA

b/w anc, sup

fibres of sup/deeper

cadaveric

7

3

clinical

13

7

Number of perforators from IRA

 

1

2

3

CADAVERIC

4

5

1

CLINICAL

7

12

1

Site of flap

 

MIDDLE 1/3

mid-prox (min ext)

ext to prox1/4

NO.OF FLAP

3

10

7

Flap length (vertical)

length

5–7CM

7–9CM

9–11CM

11–14CM

NO.OF FLAPS

4

9

1

6

Flap breadth (horizontal)

Breadth

3–4 cm

4–5 cm

5–6 cm

6–7 cm

7–8 cm

NO.OF FLAPS

6

6

4

3

1

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Prasad, R., Balakrishnan, T.M. Role of Interosseous Recurrent Artery Perforators in the Posterior Interosseous Artery Flap. J Hand Microsurg 7, 36–41 (2015). https://doi.org/10.1007/s12593-014-0161-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12593-014-0161-3

Keywords

Search

Navigation