Application of modified posterior interosseous artery island flap in complex finger replantation

Abstract

Objective To explore the surgical procedure and evaluate the treatment outcomes of transferring posterior interosseous artery island flap with a superficial vein in the flap for repairing soft tissue defects of the dorsum hand in complex finger replantation. Methods From January 2009 to January 2013, 8 cases of complex finger replantation accompanied with soft tissue defects were treated with this procedure. The superficial vein in the flap served as flow-through drainage vein for the replanted finger while the flap covered the soft tissue defect simultaneously. The proper arteries of the severed finger were anastomosed directly. The dorsal veins of the fingers were anastomosed with the superficial veins in the flaps. The areas of the harvested flaps ranged from 8.0 cm×3.0 cm to 13.0 cm×8.0 cm. Results All fingers and flaps survived uneventfully. Postoperative follow-up ranged from 6 to 24 months, with an average of 8.3 months. The flaps had good color and texture. Protective sensation was restored. Conclusion Transfer of the posterior interosseous artery flap with superficial veins can restore venous drainage of the replanted fingers and repair the hand defects in one stage. It is suitable in covering soft tissue defects of the hands in complex finger replantation cases. Key words: Surgical flaps; Hand injuries; Replantation; Posterior interosscous artery