Download PDF
CC BY 4.0 · Arch Plast Surg 2023; 50(04): 409-414
DOI: 10.1055/a-2067-5403
Hand/Peripheral Nerve
Case Report

Reconstruction of Hand Dorsum Defect Using Double Perforators-Based Anterior Interosseous Artery Island Flap: A Case Report and Description of a New Anterior Interosseous Artery Perforator

Inho Kang 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongsangbuk-do, Republic of Korea
,
Hyun Rok Lee 
2   Department of Plastic and Reconstructive Surgery, Saeson Hospital, Daejeon, Republic of Korea
,
Gyu Yong Jung 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongsangbuk-do, Republic of Korea
,
Joon Ho Lee 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongsangbuk-do, Republic of Korea
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

The anterior interosseous artery (AIA) perforator flap is not commonly used in hand dorsum reconstruction compared with alternatives. However, it is a versatile flap with several advantages. Literature on the AIA perforator flap is based on the dorsal septocutaneous branch (DSB), which branches from the AIA and passes through fascia between the extensor pollicis longus (EPL) and extensor pollicis brevis muscles. In the described case, the authors reconstructed a hand dorsum defect in a 78-year-old man using an AIA perforator flap with double perforators supplied by the DSB and a new perforator branching from the distal than DSB. No complication was encountered, and the flap survived completely. A retrospective computed tomography review revealed the presence of the new perforator in 14 of 21 patients. Two types of new perforator were observed. One passed through the ulnar side of the extensor indicis proprius (EIP) muscle and penetrated fascia between the extensor digitorum minimi and extensor digitorum communis tendons, whereas the other passed between the EPL and EIP muscles. This report describes the anatomical location and clinical application of the new AIA perforators. The double perforators-based AIA flap provides a straightforward, reliable means of reconstructing hand dorsum defects.

Keywords

anterior interosseous artery - anterior interosseous flap - perforator flap - posterior interosseous artery flap - radial artery perforator flap

Authors' Contributions

Study concept and design, data acquisition, drafting of the manuscript: I.K.; critical revision of the manuscript for important intellectual content: I.K., J.H.L.; study supervision: J.H.L.; approval of final manuscript: all authors.


Ethical Approval

The study was approved by the Institutional Review Board of Dongguk University Hospital (IRB approval no. 110757-202110-HR-04-02) and performed in accordance with the principles of the Declaration of Helsinki.


Patient Consent

The patient provided written informed consent for the publication and use of his images.




Publication History

Received: 02 October 2022

Accepted: 28 March 2023

Accepted Manuscript online:
01 April 2023

Article published online:
02 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA