Prospective observational study of clinical outcomes in using posterior interosseous free flap for finger defects.

Abstract

Finger injuries are common in hand and plastic surgery practice. There are various options for reconstructing finger defects. Moderate sized skin defects of the fingers which need flaps are commonly covered using various abdominal flaps. These conventional workhorse flaps are thick, need two-staged procedures and require the hand to be kept in acumbersome position. The radial artery or the ulnar artery flap need sacrifice amajor vessel. To address the above, we have used the posterior interosseous artery free flap to cover finger defects. This was aprospective observational clinical study done on 15 patients admitted to atertiary level hospital from July 2017 to July 2021. These patients had accidental industrial injuries with aloss of soft tissue on the fingers. There were finger fractures in 6 cases. These patients underwent posterior interosseous artery free flap cover. The flap size ranged from 6 × 3 cm to 10 × 4 cm. We had to cover the donor defects with skin graft in all our cases. Fourteen out of 15 flaps survived, with loss of one flap due to venous congestion. The mean two-point discrimination was 7.8 mm, with atotal active motion percentage of more than 70% in 11 out of 15 cases. The posterior interosseous artery flap is athin and pliable one stage flap, and may not need further flap thinning either, thereby establishing itself as asingle stage procedure and moreover not requiring sacrifice amajor vessel.