title: [Repair of skin and soft tissue defects on the wrist with reverse bi-pedicle posterior interosseous artery perforator flap].
abstract: OBJECTIVE
  To explore the curative effect of reverse bi-pedicle posterior interosseous artery perforator flap in repairing skin and soft tissue defects on the wrist.
  
  
  METHODS
  Seven patients with soft tissue defects on the wrist, including simple skin and soft tissue defects in 4 cases and skin and soft tissue defects combined with radial tendon injury in 3 cases, were hospitalized from December 2010 to March 2012. The area of skin defect on the volar side of the wrist ranged from 4.8 cm x 4.0 cm to 6.2 cm x 4.5 cm, while that on the dorsal side ranged from 3.5 cm x 3.2 cm to 6. 5 cm x 5.4 cm. These wounds were respectively caused by traffic injury (3 cases), reamer injury (2 cases), burn (1 case), and tumor resection (1 case). Reverse bi-pedicle posterior interosseous artery perforator flaps were used to repair these defects, with area of one pedicle ranging from 2.5 cm x 2.0 cm to 3.5 cm x 2.5 cm and the area of the other pedicle ranging from 2.5 cm x 2.5 cm to 4.0 cm x 3.0 cm. The donor sites were closed by suturing.
  
  
  RESULTS
  All flaps survived completely. Patients were followed up for 6 to 36 months. The color, texture, and appearance of all flaps were satisfactory. At last follow-up, distances of two-point discrimination of flaps ranged from 9 to 13 mm. The dorsal extension and palmar flexion functions of wrist were satisfactory. The results of function evaluation of 7 wrists were excellent in 6 cases and good in 1 case according to the tentative standards for the evaluation of upper extremity function of Society of Hand Surgery of Chinese Medical Association. A linear scar was formed at the donor site.
  
  
  CONCLUSIONS
  The reverse bi-pedicle posterior interosseous artery perforator flap, with advantages of flexible design, easy to achieve, less injury to donor site, and reliable blood supply, etc., is another choice for repairing skin and soft tissue defects over the wrist.
authors.affiliation: Department of Plastic Surgery and Burns , Affiliated Hospital of Zunyi Wenhu, Deng Chengliang, Li hai, China.
authors.forename: Xiuquan
authors.initials: X
authors.lastname: Li
authors.forename: Guangfeng
authors.initials: G
authors.lastname: Sun
authors.forename: Dali
authors.initials: D
authors.lastname: Wang
authors.forename: Zairong
authors.initials: Z
authors.lastname: Wei
authors.forename: Jianping
authors.initials: J
authors.lastname: Qi
authors.forename: Kaiyu
authors.initials: K
authors.lastname: Nie
authors.forename: Wenhu
authors.initials: W
authors.lastname: Jin
authors.forename: Chengliang
authors.initials: C
authors.lastname: Deng
authors.forename: Hai
authors.initials: H
authors.lastname: Li
mesh_terms: D002056:Burns; D002921:Cicatrix; D006801:Humans; D061525:Perforator Flap / Q000098:blood supply; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin; D016038:Skin Transplantation / Q000379:methods; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D013708:Tendon Injuries; D016896:Treatment Outcome; D017535:Ulnar Artery; D014945:Wound Healing; D014954:Wrist Injuries / Q000601:surgery*