Repair of soft tissue defects in the upper limbs using multiple types of posterior interosseous artery flaps

Abstract

To summarize the therapeutic effect of multiple types of posterior interosseous artery flaps for repair of soft tissue defects in the upper extremities. From March 2003 to June 2010, 42 cases with soft tissue defects in the upper limbs resulting from burn and traumatic injuries were treated using multiple types of posterior interosseous artery flaps, including retrograde flaps and composite flaps, antegrade flaps ,and free flaps. Flap size ranged from 2.5 cm x 2.0 cm-14.0 cm x 9.0 cm. The defects in the donor sites were closed directly or covered by skin graft. The conventional retrograde posterior interosseous artery flaps were used in 11 cases, the modified retrograde posterior interosseous artery flaps were used in 13 cases, the retrograde posterior interosseous artery composite flaps incorporating partial extensors were used in 2 cases, the antegrade posterior interosseous artery flaps were used in 3 cases, the free posterior interosseous artery flaps were used in 7 cases, and the free perforator flap based on the radiodorsal septocutaneous perforator of the posterior interosseous artery were used in 6 cases. Partial necrosis happened in one case at the distal portion of the flap. Muscular branch of the posterior interosseous nerve was injured in one case with conventional reverse posterior interosseous artery flaps. All the other flaps survived uneventually with no complication. All wounds were primarily healed. 32 cases were followed up for 1 to 48 months with satisfactory aesthetic and functional results both in the donor sites and in the recipient areas. The color,texture and thickness of the flaps were satisfied as well. The posterior interosseous artery flap has a constant vascular anatomy and a great flexibility, which is practical and suitable for repair of Soft tissue defect in the upper extremities arising from burn and traumatic injury.