[Clinical application of the serial flap pedicled with posterior interosseous artery and its recurrent branch].
OBJECTIVE
To explore a new surgical approach to repair skin and soft tissue defect of hands.


METHODS
Based on the anatomical study of the origin, course, branch, distribution, and anastomosis of the posterior interosseous artery and its recurrent branches in 40 upper limbs of cadavers, the posterior forearm serial flap, pedicled with the posterior interosseous artery and its recurrent branches, was designed and applied clinically in 17 cases to repair the skin and soft tissue defect of hands from August 1998 to July 2000. The size of flaps ranged from 7 cm x 5 cm to 15 cm x 10 cm. All of the cases were followed up for 3 weeks to 6 months.


RESULTS
The anatomy study showed that the posterior forearm serial flap had long vascular pedicle, suitable thickness and large skin area. The clinical application indicated that the flaps survived in 16 cases. But flap necrosis at the distal end, sized 2 cm x 3 cm, was observed in one case, in which the defect was repaired by delayed skin grafting,


CONCLUSIONS
The posterior forearm serial flap pedicled with the posterior interosseous artery and its recurrent branch have the character of avoidance of sacrificing the major arteries of the extremity, longer vascular pedicle, larger area and suitable thickness. The posterior forearm serial flap is a safe and easily manipulated surgical approach to repair the skin and soft tissue defect of the hands, especially of the thumb, palm, and proximal part of the fingers.
Lu
S W
SW
Department of Orthopedics, 458th Hospital of PLA, Guangzhou Guangdong, P. R. China 510602.
Tang
M L
ML
Pen
Y B
YB
D000293:Adolescent; D000328:Adult; D001158:Arteries; D005260:Female; D005542:Forearm / Q000098:blood supply* / Q000601:surgery; D006085:Graft Survival; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply