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The reversed radial forearm flap is considered the workhorse flap for hand reconstruction, while the posterior interosseous artery (PIA) flap did not take the same interest. This paper presents 25 cases with ulnar side hand defects that was reconstructed with PIA flap with 22 flaps survived (88%). The PIA flap seems a good option and should be considered as another option for hand coverage when the surgeon prefers not to use free tissue transfer or the radial artery flap. The flap should be learned to senior and junior reconstructive surgeons, because familiarity with the flap anatomy lessens the operative time greatly and makes surgical dissection easier.

The Reliability of the Reversed Flow Posterior Interosseous Flap for the Coverage of Ulnar Hand Defects: A Series of 25 Cases