[Soft-tissue coverage of the hand using the posterior interosseous artery flap].
Significant trauma, severe bacterial infections and tumour resections of the hand are often complicated by primary or secondary soft-tissue defects. The Posterior Interosseous Artery Flap (PIA), described by Zancolli and Angrigiani in 1985 offers one possibility for soft-tissue coverage. In this abstract, we present the results of 35 patients who were treated with distally based PIA flap reconstructions during the years 1998 to 2003. 24 patients were available for one-year follow-up and beyond.


RESULTS
Long-term follow-up demonstrates excellent colour and texture match with reliable soft-tissue coverage. Two of the 33 flaps were lost because of ischemic necrosis. The incidence of distal local ischemia was predictable when the flaps were extended to the level of the PIP joint or beyond.


CONCLUSIONS
The PIA flap affords a very durable and aesthetic option for soft-tissue coverage of the dorsum of the hand. The flap donor site can usually be closed primarily with little to no morbidity. In comparison to other local and distally based flaps such as the radial forearm flap, major blood vessels are spared. In summary, the PIA flap should be considered as a reliable and judicious alternative to free microvascular transfer procedures for soft-tissue defects of the hand proximal to the level of the PIP joint.
Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik an der Eberhard-Karls-Universität, Tübingen. czwick@bgu-tuebingen.de
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Zwick
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Schmidt
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Rennekampff
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Schaller
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000637:transplantation*; D001424:Bacterial Infections / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006225:Hand / Q000098:blood supply / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications / Q000209:etiology; D018461:Soft Tissue Infections / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*