Abstract

FERNANDEZ GARCIA, A.; FERNANDEZ PASCUAL, C.; CANOVAS SANCHIS, S.  and  ALONSO ROSA, S.. Propeller interoseous posterior perforator flap: A new reconstructive procedure. Cir. plást. iberolatinoam. [online]. 2009, vol.35, n.1, pp.1-8. ISSN 1989-2055.

The distally-based posterior interosseous flap is a versatile and useful technique in upper limb reconstruction. This flap is based on the integrity of the dorsal carpal anastomosis between the anterior interosseous artery and the posterior interosseous artery. Hence, when the dorsal carpal anastomosis is not available, it is not possible to perform a distally-based posterior interosseous flap. We report a propeller perforator flap proximallybased, available without the dorsal carpal supply, and useful for the coverage of the distal third of the forearm, wrist and hand. We report the surgical technique, its applications, advantages and disadvantages and review the use o this flap in different clinical cases. A patient suffered a severe crush injury of their left upper limb. He presented osteosynthesis plate exposure in the radius and thrombosis of the revascularization anastomosis. The absence of reverse flow in the posterior interosseous artery was proven with Doppler Ultrasounds. A propeller interosseous posterior perforator flap was performed to cover a new by-pass and the osteosynthesis plate. Another patient suffered an automobile accident. He presented closed fractures of radius and ulna of their left upper limb. The radial column of carpus suffered a severe crush injury. After the osteosynthesis, a propeller interosseous posterior perforator flap was performed. The flap provided appropriate coverage of the dorso-radial aspect of the wrist and hand. In our clinical cases the propeller interosseous posterior perforator flap provided excellent coverage of the carpus and hand with low donor site morbidity. Propeller interosseous posterior perforator flap provide a versatile and reliable coverage option in upper limb reconstruction, available in absence of the dorsal carpal anastomosis and without sacrifice of the interosseous posterior artery.

Keywords : Propeller flap; Perforator flap; Posterior interosseous.

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