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“Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”

SUMMARY: Flap options for upper limb reconstruction have increased due to better understanding of its vascular anatomy. The posterior interosseus artery flap (PIAF) is used to cover defects of the wrist, hand, proximal thumb, and first web space. This flap has many advantages but requires good knowl...

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Autores principales: Kelada, Melad N., Salem, Rasha R., Eltohfa, Youssef A., Ghozlan, Naser A., Kholosy, Hassan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275144/
https://www.ncbi.nlm.nih.gov/pubmed/35820834
http://dx.doi.org/10.1186/s12891-022-05630-0
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author Kelada, Melad N.
Salem, Rasha R.
Eltohfa, Youssef A.
Ghozlan, Naser A.
Kholosy, Hassan M.
author_facet Kelada, Melad N.
Salem, Rasha R.
Eltohfa, Youssef A.
Ghozlan, Naser A.
Kholosy, Hassan M.
author_sort Kelada, Melad N.
collection PubMed
description SUMMARY: Flap options for upper limb reconstruction have increased due to better understanding of its vascular anatomy. The posterior interosseus artery flap (PIAF) is used to cover defects of the wrist, hand, proximal thumb, and first web space. This flap has many advantages but requires good knowledge about the anatomy of the posterior interosseus artery (PIOA) and its perforators. METHODS: Twenty upper extremity cadaveric specimens were injected with red latex, Fine dissection of the PIOA and its perforators took place; the perforators were counted, measured, described and photographed. Twenty patients with dorsal hand defects, had PIAF. Cases have Post-operative care and followed up for 6 months post-operative. RESULTS: The PIOA was constant in all cadaveric dissections and gave off 4–8 septocutaneous perforators along its course between the extensor carpi ulnaris (ECU) and extensor digitorum (EDM) muscles. The mean distance of the distal most perforator in the middle third forearm from the ulnar styloid was 10.39 ± 1.54 cm. The anastomosis between the PIOA and the anterior interosseus artery (AIOA) was there in all specimens. Venous congestion occurred in 10% of the cases and was managed conservatively. Necrosis of the distal third of the flap was inevitable in one case; excellent results were obtained in the other cases 90%. CONCLUSIONS: The posterior interosseus artery flap is an excellent perforator flap for hand reconstruction preserving the ulnar and radial artery; but it has a possible complications such as venous congestion or partial flap necrosis that could be managed conservatively. LEVEL OF EVIDENCE: II.
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spelling pubmed-92751442022-07-13 “Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application” Kelada, Melad N. Salem, Rasha R. Eltohfa, Youssef A. Ghozlan, Naser A. Kholosy, Hassan M. BMC Musculoskelet Disord Research SUMMARY: Flap options for upper limb reconstruction have increased due to better understanding of its vascular anatomy. The posterior interosseus artery flap (PIAF) is used to cover defects of the wrist, hand, proximal thumb, and first web space. This flap has many advantages but requires good knowledge about the anatomy of the posterior interosseus artery (PIOA) and its perforators. METHODS: Twenty upper extremity cadaveric specimens were injected with red latex, Fine dissection of the PIOA and its perforators took place; the perforators were counted, measured, described and photographed. Twenty patients with dorsal hand defects, had PIAF. Cases have Post-operative care and followed up for 6 months post-operative. RESULTS: The PIOA was constant in all cadaveric dissections and gave off 4–8 septocutaneous perforators along its course between the extensor carpi ulnaris (ECU) and extensor digitorum (EDM) muscles. The mean distance of the distal most perforator in the middle third forearm from the ulnar styloid was 10.39 ± 1.54 cm. The anastomosis between the PIOA and the anterior interosseus artery (AIOA) was there in all specimens. Venous congestion occurred in 10% of the cases and was managed conservatively. Necrosis of the distal third of the flap was inevitable in one case; excellent results were obtained in the other cases 90%. CONCLUSIONS: The posterior interosseus artery flap is an excellent perforator flap for hand reconstruction preserving the ulnar and radial artery; but it has a possible complications such as venous congestion or partial flap necrosis that could be managed conservatively. LEVEL OF EVIDENCE: II. BioMed Central 2022-07-12 /pmc/articles/PMC9275144/ /pubmed/35820834 http://dx.doi.org/10.1186/s12891-022-05630-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kelada, Melad N.
Salem, Rasha R.
Eltohfa, Youssef A.
Ghozlan, Naser A.
Kholosy, Hassan M.
“Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”
title “Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”
title_full “Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”
title_fullStr “Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”
title_full_unstemmed “Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”
title_short “Posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”
title_sort “posterior interosseus artery flap for hand reconstruction: anatomical basis and clinical application”
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275144/
https://www.ncbi.nlm.nih.gov/pubmed/35820834
http://dx.doi.org/10.1186/s12891-022-05630-0
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