Publication:

Hand and wrist reconstruction with a posterior interosseus artery flap: case report and literature review

The posterior interosseous artery flap (PIAF) is an invaluable tool in reconstructive hand surgery, providing a versatile and reliable option for soft tissue defects while maintaining the major vascular axes of the upper limb. We provide a comprehensive review of the PIAF, describe the relevant vascular anatomy, including the origin and course of the posterior interosseous artery (PIOA), and discuss the many advantages of this flap, such as excellent tissue match and the avoidance of major artery sacrifice. Also, discussed are the surgical technique and possible complications, particularly venous congestion, and their management. Finally, we address the disadvantages of the procedure, including the challenging dissection near the posterior interosseous nerve and the limitations in flap width, to provide a balanced perspective for the reconstructive surgeon.