Posterior Interosseous Artery Flap: Advanced Techniques for Soft Tissue Defect Reconstruction

This book chapter presents a case report and discussion on the use of the posterior interosseous artery (PIA) flap for reconstructive surgery in a patient with a posttraumatic soft tissue defect of the dorsum of the left hand, exposing tendons and bones. The case presentation describes the preoperative condition and the need for reconstruction. The surgical intervention involved debridement and reconstruction using an islanded PIA flap, with the donor site grafted with split-thickness skin grafts.

The operative procedure included wound debridement, marking of the PIA flap, flap elevation, and reconstruction of the soft tissue defect. The postoperative period remained uneventful, and satisfactory results were observed during follow-up examinations at 3 and 6 weeks.

The discussion section introduces the posterior interosseous artery flap technique as a valuable reconstructive option for soft tissue defects in the hand, wrist, and forearm regions. The surgical technique is described, including patient evaluation and planning, flap design and marking, incision and flap elevation, and flap transposition and closure. The advantages of the technique, such as robust blood supply, adequate tissue volume, versatility, and minimized donor site morbidity, are highlighted. The limitations, including considerations of vascular anatomy, flap reach and tension, and potential complications, are also discussed.

The abstract emphasizes the significance of the posterior interosseous artery flap technique in reconstructive surgery, particularly in cases of soft tissue defects in the hand, wrist, and forearm. It highlights the importance of careful patient selection, precise surgical technique, and postoperative monitoring to achieve optimal outcomes and minimize complications. By understanding the principles and considerations of the PIA flap technique, surgeons can effectively address complex defects and provide functional and aesthetically pleasing reconstructions for their patients.