The versatile uses of the posterior interosseous forearm flap

Abstract 

Sixteen patients with a posterior interosseous artery (PIA) forearm flap are presented. Fourteen distally based fasciocutaneous PIA island flaps, one distally based PIA fascial flap and one PIA free flap have been performed to cover defects of the dorsum of the hand (10), first web space (5) and lower leg (1). The size of the island flaps ranged from 3 to 5 cm in width and 6 to 13 cm in length. The maximum size of skin island was 13×4 cm. The area of reach for the distally based PIA flap was the MP joint. Venous congestion with partial flap loss was seen in two cases, radial nerve palsy with an incomplete extension of the fourth and fifth finger in one case. The donor site was closed primarily most times. In the majority of cases the scarring at the donor site was inconspicuous. There was practically no functional loss. The flaps contoured well to the recipient site and had good texture and color match.