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The skin on the dorsal side of the forearm can provide a thin and pliable skin suitable for first web space reconstruction. Although previous reports have described the use of the posterior interosseous artery (PIA) flap as a reverse-flow flap for treatment of first web space contracture, only a few have addressed its use as a free flap for this purpose. The caliber of the concomitant veins accompanying the PIA is usually small, which may give rise to a problem in the treatment. There have been reported five articles regarding the first web reconstruction using free PIA flaps. Only three of them mentioned the venous anastomosis method. The information is lacking on the venous anastomosis of free PIA flap. In this article, we report the first web reconstruction using free PIA flaps, focusing on selection of the type of venous anastomosis. Archives of Hand and Microsurgery

Free Posterior Interosseous Artery Flap for Treatment of First Web Space Contracture: Methods of Venous Anastomosis