Free posterior interosseous dorsal perforator flap for soft-tissue coverage of the finger

Abstract

Objective To introduce the clinical experience and surgical methods of soft-tissue coverage of the finger using a free posterior interosseous dorsal perforator flap.Methods From May 2006 to May 2011,29 cases of soft tissue defects of the finger were treated.The posterior interosseous dorsal perforator was located by color Dopplar ultrasound preoperatively for flap design.The deep fascia was not included during flap harvesting.The posterior interosseous dorsal artery was anastomosed to the proper digital artery,while the subcutaneous vein in the flap was anastomosed to the dorsal vein of the finger.Alternatively the dorsal interosseous vein was anastomosed to the finger palmar subcutaneous vein.The cosmetic appearance of the donor and recipient sites were evaluated in a follow-up visit.Results Twenty-seven flaps survived uneventfully.Venous crisis occurred in 2 flaps,one of which had complete necrosis and the other had partial epidermal necrosis.After 6 to 12 months' postoperative follow-up,all patients achieved a cosmetically acceptable result.Conclusion It is a good method to repair skin defect of the finger using a free posterior interosseous dorsal perforator flap without including the deep fascia.Because of the added advantage of reducing donor-site morbidity,posterior interosseous perforator flaps have become the authors' preferred option in reconstructive cases of the finger. Key words: Surgical flaps; Finger injuries; Posterior interosseous vessel