title: Tripaddle Posterior Interosseous Artery Flap Design for 3-Finger Defects: An Evaluation of 3 Surgical Approaches.
abstract: BACKGROUND
  The tripaddle posterior interosseous artery (PIA) flap can be used for multifinger defect resurfacing, but interpatient variations in perforator distribution remain an ongoing challenge when using this approach. This study aims to evaluate the efficacy of 3 different tripaddle PIA perforator flap designs according to the PIA perforator distribution for the repair of 3-finger defects.
  
  
  METHODS
  In accordance with the size of the 3-finger defects and the position of the perforators, a tripaddle flap was designed on the multiple perforators of the descending branch of the PIA in the distal two thirds of the forearm. Patients received 1 of 3 distinct tripaddle PIA perforator flap designs based on perforator distributions of the PIA.
  
  
  RESULTS
  Three cases of 3-finger defects were repaired with type A trefoil-shaped tripaddle flaps, whereas 4 cases were repaired with type B modified trefoil-shaped tripaddle flaps, and the other 3 cases were repaired with type C chain-shaped tripaddle flaps. All flaps survived except 2 paddles with tip necrosis. After 9.1 months of mean follow-up, 9 of the 10 cases demonstrated satisfactory cosmetic appearance, whereas the last case required a debulking procedure in the second stage.
  
  
  CONCLUSIONS
  The free tripaddle PIA perforator flap is an effective option for repairing 3-finger skin defects. Various flap designs based on the PIA perforator distribution allow for more individualized treatment approaches.
authors.affiliation: From the *Department of Hand Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang; and †Departments of Head and Neck Surgery and Oncology Plastic Surgery, Hunan Province Cancer Hospital of Xiangya Medical School, Central South University, Changsha, People's Republic of China.
authors.forename: Kuang-Wen
authors.initials: KW
authors.lastname: Li
authors.forename: Da-Jiang
authors.initials: DJ
authors.lastname: Song
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Song-Lin
authors.initials: SL
authors.lastname: Xie
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000601:surgery; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome