Antebrachial reverse island flap with pedicle of posterior interosseous artery: a report of 90 cases  Lai Jin Lu, Xu Gong, Zhi Gang Liu, Zhi Xin Zhang  British Journal of Plastic Surgery  Volume 57, Issue 7, Pages 645-652 (October 2004) DOI: 10.1016/j.bjps.2004.05.027

Figure 1 There are 5–13 cutaneous arteries arising from the posterior interosseous artery. The fascial network is composed of these cutaneous arteries, supplying the dorsal skin of the forearm. British Journal of Plastic Surgery 2004 57, 645-652DOI: (10.1016/j.bjps.2004.05.027)

Figure 2 At the dorsum of the wrist, there is an arterial arch between the posterior interosseous artery and dorsal branch of anterior interosseous artery, which is 2.5 cm proximal to ulnar styloid process. The anastomotic arc appeared in 48 cases of 50 specimens (96%), the diameter of arterial arc is 0.7–1 mm (average of 0.8 mm). British Journal of Plastic Surgery 2004 57, 645-652DOI: (10.1016/j.bjps.2004.05.027)

Figure 3 The diagrams showing the operative procedure. (A) The defect of the first web space is repaired using the reverse posterior interosseous flap. (B) The donor site defect is repair by skin graft. (C) Postoperative view. British Journal of Plastic Surgery 2004 57, 645-652DOI: (10.1016/j.bjps.2004.05.027)

Figure 4 Case 1. (A) Soft tissue defect with infection of the dorsum of right hand due to a thermal injury, with exposure of tendons. (B) A 14 by 10 cm reverse island flap with pedicle of 7 cm in length survived and the wound healed primarily. British Journal of Plastic Surgery 2004 57, 645-652DOI: (10.1016/j.bjps.2004.05.027)

Figure 5 Case 2. (A) The first web space contracture of left hand due to burn injury. (B) A 14 by 18 cm reverse flap with pedicle of 7 cm in length was used to cover the skin defect of the first web space, and the angle of the first web space was enlarged to 60°. Opposition of thumb was restored by 10 months postoperatively. British Journal of Plastic Surgery 2004 57, 645-652DOI: (10.1016/j.bjps.2004.05.027)

Figure 6 Case 3. (A) Electric burn injury with the first web space contracture. (B) A 12 by 8 cm reverse flap with the pedicle of 8 cm in length was used to repair the first web space, and (C) the angle of the first web space was 65°. British Journal of Plastic Surgery 2004 57, 645-652DOI: (10.1016/j.bjps.2004.05.027)

Figure 7 Case 4. (A) Degloving injury of the right thumb due to the machine crush. (B) A 7 by 5 cm reverse flap was used to reconstruct the thumb, the cutaneous nerve in the flap was anastomosed with digital nerve. The sensation and function of reconstructed thumb was similar to the opposite side. British Journal of Plastic Surgery 2004 57, 645-652DOI: (10.1016/j.bjps.2004.05.027)