OBJECTIVETo assess and review the indications and methods of the reversed posterior interosseous artery flap for repairing soft tissue defects of the hand.

METHODSIn the series, three types of flaps were utilized including the reversed posterior interosseous artery flap, the expanded reversed posterior interosseous artery flap and the reversed posterior interosseous artery conjoint flap. 78 clinical cases were treated with this method, in which 12 cases used the expanded reversed posterior interosseous artery flap and 10 cases used the reversed posterior interosseous artery conjoint flap. The flap,ranged from 8 approximately 6 cm to 14 approximately 8 cm, was used to repair the defects of the dorsal hand as far as to the fingerweb. The anatomy of the posterior interosseous artery was observed in the surgical dissection.

RESULTSThe posterior interosseous artery was consistently identified in all the 78 cases. In 4 cases, the artery terminated in the middle third of the dorsal forearm, therefore an alternative method of reconstruction was used. In the 53 cases of reversed posterior interosseous flaps, 49 cases healed uneventfully and 4 cases suffered necrosis in the distal border of the flap, but subsequently healed spontaneously. 12 cases of expanded flaps survived well and the donor sites were directly approximated. In the 9 cases of conjoint flaps based on the posterior interosseous artery, 7 cases healed uneventfully and 2 cases suffered delayed healing because of flap necrosis of the distal part. The satisfactory appearance and hand function were achieved postoperatively in all cases.

CONCLUSIONSThe flap is a better choice for repairing the soft tissue defects of the hand. The different type of flaps can be selected to meet the clinical requirements of reconstruction. It is suggested that the artery variation should be assessed preoperatively.