The distally based posterior interosseous artery flap is routinely used for covering soft tissue defects on the hand. However problems in dissecting the flap can arise due to an inconstant vascular anatomy. A case is described where it was not possible to employ a distally based posterior interosseous artery flap because of the absence of the posterior interosseous vascular axis and an unusually high bifurcation of the brachial artery. The preoperative Doppler investigation showed only a positive retrograde blood flow in the area of the distal anastomosis to the anterior interosseous artery. After the arteriogram, the defect was finally closed with a free lateral arm flap. The authors point out that a complete Doppler investigation by a skilled investigator is necessary to detect unexpected vascular variations and to accurately indicate the patients on whom one should perform a preoperative angiogram.
European Journal of Plastic Surgery – Springer Journals
Published: Dec 15, 2000
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