| Abstrakt: |
The posterior interosseous flap with external pedicle is characterized by the inclusion of the quasi-totality of the posterior forearm fascia to the septum of the posterior interosseous vessels, the flap reaching the defect without tunnelization of this pedicle. The coverage of distal defects in the hand without dangerous dissection of the distal part of the interosseous posterior pedicle, the coverage of large skin defects without sacrificing more skin in the donor area by simply grafting this pedicle, and the possibility of secure immediate defatting of this flap are the main advantages of this technique. From February 1997 to March 2001, there were 12 cases of PIO flaps with external pedicle in patients aged 16 to 65 years. This skin coverage involved the first web space in eight cases, the first and second web spaces in two cases, and the dorsal side of the metacarpophalangeal joints in two other cases. These skin defects were due to severe retractile sequellae of thermic and electrical burns, and their sizes varied from 5×7 cm to 6×12 cm. In all cases, the dissection of the posterior interosseous pedicle stopped 2 cm before its anastomosis with the anterior interosseous artery. In three cases of obese patients, immediate defatting was peformed without any complications. All patients benefitted from an orthesis that kept the wrist in extenstion for three weeks to protect the pedicle, which was sectionned at this date. No complications were reported. |
