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

  • 129 Accesses

  • 6 Citations


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.

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

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8


  1. 1.

    Jeng S-F, Wei F-C (1998) The distally based forearm island flap in hand reconstruction. Plast Reconstr Surg 102:400

  2. 2.

    Zancolli EA, Angrigiani C (1988) Posterior interosseous island forearm flap. J Hand Surg (Br) 13:130

  3. 3.

    Landi A, Luchetti R, Soragni O, De Santis G, Sacchetti GL (1991) The distally based posterior interosseous island flap for the coverage of skin loss of the hand. Ann Plast Surg 27:527–536

  4. 4.

    Balakrishnan G, Kumar BS, Hussain SA (2003) Reverse-flow posterior interosseous artery flap revisited. Plast Reconstr Surg 111(7):2364–9

  5. 5.

    Iwuagwu FC, Wilson D, Bailie F (1999) The use of skin grafts in postburn contracture release: a 10-year review. Plast Reconstr Surg 103(4):1198–204

  6. 6.

    Uygur F, Duman H, Celiköz B (2008) Use of free anterolateral thigh perforator flap in the treatment of chronic postburn palmar contractures. Burns 34(2):275–80

  7. 7.

    Lu LJ, Wang SF (1986) The posterior interosseous flap: a report of 6 cases. The Second Symposium of the Chinese Association of Hand Surgery, Tsingtao City, pp 187–191

  8. 8.

    Penteado CV, Masquelet AC, Chevrel JP (1986) The anatomic basis of the fasciocutaneous flap of the posterior interosseous artery. Surg Radiol Anat 8:209–215

  9. 9.

    Richard BM (1995) Distally based posterior interosseous island flap. Br J Plast Surg 48:258

  10. 10.

    Mazzer N, Barbieri CH, Cortez M (1996) The posterior interosseous forearm island flap for skin defects in the hand and elbow. A prospective study of 51 cases. J Hand Surg [Br] 21:237–243

  11. 11.

    Giunta R, Lukas B (1998) Impossible harvest of the posterior interosseous artery flap: a report of an individualised salvage procedure. Br J Plast Surg 51:642–645

  12. 12.

    Costa H, Comba S, Martins A et al (1991) Further experience with the posterior interosseous flap. Br J Plast Surg 44:449–455

  13. 13.

    Muhlbauer W, Herndl E, Stock W (1982) The forearm flap. Plast Reconstr Surg 70:336–342

  14. 14.

    Song R, Gao Y, Song Y et al (1982) The forearm flap. Clin Plast Surg 9:21–26

  15. 15.

    Angrigiani C, Grilli D, Dominikow D et al (1993) Posterior interosseous reverse forearm flap: experience with 80 consecutive cases. Plast Reconstr Surg 92:285–293

  16. 16.

    Shibata M, Iwabuchi Y, Kubota S et al (1997) Comparison of free and reversed pedicled posterior interosseous flap. Plast Reconstr Surg 99:791–802

  17. 17.

    Chen HC, Cheng MH, Schneeberger AG et al (1998) Posterior interosseous flap and its variations for coverage of wounds. J Trauma 45:570–574

  18. 18.

    Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K (1998) Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases. Plast Reconstr Surg 102:1517

  19. 19.

    Shieh SJ, Chiu HY, Yu JC et al (2000) Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation. Plast Reconstr Surg 105:2349

  20. 20.

    Luo S, Raffoul W, Luo J et al (1999) Anterolateral thigh flap: a review of 168 cases. Microsurgery 19:232

  21. 21.

    Yilmaz M, Karatas O, Barutcu A (1998) The distally based superficial sural artery island flap: clinical experiences and modification. Plast Reconstr Surg 102:2358–2367

Download references


The authors do not have any financial interests or commercial associations to disclose.

Author information

Correspondence to Ahmed Hassan El-Sabbagh.

Electronic supplementary material

Below is the link to the electronic supplementary material.

hearing of the perforator after setting of the flap. (AVI 7168 kb)

Movie 1

hearing of the perforator after setting of the flap. (AVI 7168 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

El-Sabbagh, A.H., Zeina, A.A.E., El-Hadidy, A. et al. Reversed Posterior Interosseous Flap: Safe and Easy Method for Hand Reconstruction. J Hand Microsurg 3, 66–72 (2011).

Download citation


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