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
