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The Fascia-Only Reverse Posterior Interosseous Artery Flap
Rafael G Jakubietz1, Silvia Bernuth1, Karsten Schmidt1
1Department of Trauma, Hand, Plastic, and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
The Journal of Hand Surgery
|July 24, 2018
Summary
The fascia-only reversed posterior interosseous artery flap offers a viable alternative for hand soft tissue reconstruction, providing comparable tissue quality without requiring microsurgery. This pedicled flap is a valuable option for covering exposed tendons.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Fascia flaps are crucial for hand soft tissue reconstruction, especially when thin, pliable coverage is needed for exposed tendons.
- The reversed posterior interosseous artery flap is a pedicled option that avoids free tissue transfer, simplifying the reconstructive process.
Purpose of the Study:
- To evaluate the efficacy and outcomes of the fascia-only reversed posterior interosseous artery flap for hand soft tissue reconstruction.
- To compare this technique with other fascia flaps, particularly the temporalis fascia flap.
Main Methods:
- A retrospective review of 5 patients who underwent soft tissue reconstruction using a fascia-only reversed posterior interosseous artery flap.
- The surgical technique involves harvesting only the fascia through a straight incision, similar to fasciocutaneous flap harvest but without the skin component.
Main Results:
- No instances of flap loss were reported in the study.
- Two patients experienced distal wound dehiscence, which successfully healed via secondary intention.
- No complications such as venous congestion or iatrogenic injury to motor nerves of the extensor muscles were observed.
Conclusions:
- The fascia-only reversed posterior interosseous artery flap is a readily available, pedicled reconstructive option for the hand.
- It offers comparable tissue quality to the temporalis fascia flap but avoids the need for microsurgery and free tissue transfer.
- Advantages include a confined donor site on the ipsilateral extremity and improved cosmesis due to the absence of a skin graft at the donor site.
Keywords:
Fascia flapreverse posterior interosseous artery flapsoft tissue reconstruction of the handMore Related Videos
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