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Evaluation of the outcomes of reverse posterior interosseous artery flap for soft tissue defect coverage of the forearm and hand
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Abstract
Objective: This study aimed to evaluate the clinical effectiveness of the reverse posterior interosseous artery (RePIA) flap in covering soft tissue defects of the distal forearm and hand.
Subjects and methods: A prospective case series was conducted at the Department of Trauma and Orthopedic Surgery, Thong Nhat Hospital, between January 2021 and January 2025. Sixteen patients with soft tissue defects in the distal forearm or dorsal hand underwent reconstruction using the RePIA flap. Outcomes assessed included flap survival, postoperative complications (marginal necrosis, venous congestion, infection), hospital stay, and functional recovery time. Preoperative Doppler ultrasonography was used to evaluate vascular anatomy.
Results: All flaps survived completely without total necrosis. Minor marginal necrosis occurred in three patients (18.75%) and healed with conservative management. Venous congestion was observed in two cases (12.5%) and resolved through non-surgical treatment. The average hospital stay was 12.6 days, and patients resumed normal activities after an average of 8.5 weeks. Longer recovery times were observed in patients with comorbidities or flap sizes larger than 50 cm² (p < 0.05).
Conclusion: The RePIA flap is a reliable and effective reconstructive option for moderate-sized soft tissue defects of the forearm and hand. It offers high flap survival rates, minimal complications, and favorable functional outcomes while preserving the major arterial supply of the upper limb. Further large-scale studies are needed to validate these findings.
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Keywords
Reverse posterior interosseous artery flap, soft tissue defect, reconstructive microsurgery, functional recovery
References
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