[An appropriate alternative for the reconstruction of soft tissue defects in the hand and the wrist: the distally-based island posterior interosseous flap].

Objectives: We evaluated the use of a distally-based island posterior interosseous flap in patients with soft tissue defects of the hand and the wrist.

Methods: The distally-based island posterior interosseous flap was used to cover soft tissue defects in eight patients (1 female, 7 males; mean age 30 years; range 9 to 51 years). Of these, six patients had crush injuries, and two patients had wrist flexion contracture due to high-voltage burns. The defects were in the volar aspect of the wrist in two patients, in the dorsum of the thumb metacarpal in two patients, and in the dorsum of the metacarpals in four patients. The mean follow-up period was 3 months (range 2 to 7 months).

Results: The results were satisfactory in all but one patient. Flap necrosis developed in one patient with crush injury of the hand and blunt injury of the forearm. Venous congestion of the flap was encountered in four patients, but none resulted in flap necrosis during the follow-up period.

Conclusion: The distally-based island posterior interosseous flap may be easily and safely employed in the coverage of soft tissue defects of the hand and the wrist due to such advantages as minimal donor area morbidity, an acceptable cosmetic appearance, and a more simple dissection than required for other surgical flaps.