Posterior interosseous forearm flap in reconstruction of first web space.

Use of a fascial flap is often required for reconstruction of a skin defect on the dorsum of the hand. For this purpose, a distally based dorsal forearm fasciosubcutaneous flap based on the perforators of the posterior interosseous artery was developed. The distally based dorsal forearm fasciosubcutaneous flap and especially the posterior interosseous artery flap are a convenient and reliable alternative for reconstructing skin defects of the hand after the release of post-burn adduction contracture of web space I involving vital structure exposure. Although the posterior interosseous artery flap is suitable for covering dorsal skin defects of the hand and avoids interference with the forearm's two main arteries, the dissection of the vascular pedicle is frequently quite complex and tedious.