Reliability and Versatility of Posterior Interosseous Artery Flap in Reconstructing Hand Soft Tissue Defects

Abstract

Background: The posterior interosseous artery flap (PIAF) is indicated in the reconstruction of soft tissue defects on the 1 st webspace, dorsal & volar aspect of the hand and wrist. The PIAF is a long-lasting and aesthetically pleasing solution for covering deficiencies in soft tissue when bone and/or tendons are exposed on the dorsal & palmer sides of the thumb, hand & wrist.Objective: This research aimed to assess the PIA fasciocutaneous flap in reconstruction of hand defects in terms of aesthetic appearance, hand function & morbidity at the donor site.Methods: This case series research was carried out on 15 cases with soft tissue hand defects. All cases underwent full history taking, clinical evaluation, laboratory investigations and radiological evaluation with plain X-rays.Results: Regarding the scar assessment, it was good in 12 (80%) cases and fair in 3 (20%). DASH score ranged from 30-60 with a mean of 38.7±11.25. Regarding donation site problems, only 2 (13%) cases had cold intolerance and numbness. Regarding the incidence of complications, there were 1 (7%) patient had distal flap necrosis and 1 (7%) had venous congestion. The hospital stay of the studied cases ranged from 4-10 days with a mean of 6.9±1.83 day. The follow-up of the studied cases ranged from 3-6 months with a mean of 4.3±1.11 months. Conclusions:The reverse-flow posterior interosseous artery flap (PIAF) is a reliable and versatile flap for defects resurfacing of mild to moderate size on the dorsal & palmar aspect of the hand up to the MPJ, thumb up to the IP joint & 1 st web space.