Free Posterior Interosseous Artery Flap for Treatment of First Web Space Contracture: Methods of Venous Anastomosis

Masao Fujiwara; Yuki Matsushita; Yoshikane Maeba; Ayano Suzuki; Hidekazu Fukamizu; Yoshiki Tokura

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자료유형: 학술저널

저자정보: Masao Fujiwara (Hamamatsu University School of Medicine) Yuki Matsushita (Hamamatsu University School of Medicine) Yoshikane Maeba (Hamamatsu University School of Medicine) Ayano Suzuki (Hamamatsu University School of Medicine) Hidekazu Fukamizu (Hamamatsu University School of Medicine) Yoshiki Tokura (Hamamatsu University School of Medicine)

저널정보: 대한수부외과학회 Archives of Hand and Microsurgery Archives of Hand and Microsurgery Vol.24 No.4

발행연도: 2019.1

수록면: 408 - 415 (8page)

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Purpose: First web space widening is crucial in the hand function. The skin on the dorsal side of the forearm can provide a thin and pliable skin suitable for first web space reconstruction. Although previous reports have described the use of the posterior interosseous artery (PIA) flap as a reverse-flow flap for treatment of first web space contracture, only a few have addressed its use as a free flap for this purpose. The caliber of the concomitant veins accompanying the PIA is usually small, which may give rise to a problem in the treatment.Methods: Seven patients with first web space contracture were treated with a free PIA flap and the details of the venous anastomosis method were elucidated.Results: Six of seven flaps survived. In a post-burn case, a flap was lost by late thrombosis. The PIA is anastomosed end-to-end to the dorsal branch of the radial artery. There are two choices for the recipient venous pedicle: concomitant veins of radial artery and a tributary of the cephalic vein. In our cases, there were four types of venous anastomosis. An average postoperative increase of the thumb radial abduction was 36° and that of the palmar abduction was 35°.Conclusion: Since the caliber of the concomitant veins accompanying the PIA is small, a careful scheme for venous anas-tomosis is essential in the treatment of first web space contracture using the free PIA flap.

#Free posterior interosseous artery flap #First web space contracture #Venous anastomosis

참고문헌 (14)

참고문헌 신청

Tonkin MA / 1989 / The posterior interosseous artery free flap / J Hand Surg Br 14:215~217

Chen HC / 1996 / Microvascular free posterior interosseous flap and a comparison with the pedicled posterior interosseous flap / Ann Plast Surg 36:542~550

Park JJ / 1997 / Posterior interosseous free flap : various types / Plast Reconstr Surg 100:1186~1197

Shibata M / 1997 / Comparison of free and reversed pedicled posterior interosseous cutaneous flaps / Plast Reconstr Surg 99:791~802

Cavadas PC / 2001 / Posterior interosseous free flap with extended pedicle for hand reconstruction / Plast Reconstr Surg 108:897~901

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