Posterior interosseous artery flap for severe hand injuries: Outcomes of reconstruction combined with local and regional flaps

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dc.contributor.authorErtem, Hakan
dc.contributor.authorAdıgüzel, İbrahim Faruk
dc.contributor.authorÖzdeş, Hüseyin Utku
dc.contributor.authorAslantürk, Okan
dc.contributor.authorErtem, Kadir
dc.date.accessioned2026-04-04T13:18:55Z
dc.date.available2026-04-04T13:18:55Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractBackground Severe hand injuries with extensive soft-tissue loss present a significant reconstructive challenge. Achieving stable coverage while preserving hand function often necessitates the combined use of regional and local flaps. The posterior interosseous artery (PIA) flap, in combination with regional flaps harvested from non-salvageable digits, may offer an effective solution. Methods A retrospective analysis was performed on patients with severe hand injuries who underwent reconstruction using a PIA flap between 2022 and 2025. Patients were treated with either an isolated PIA flap or a PIA flap combined with local flaps, including fillet flaps harvested from non-salvageable digits or rotational flaps, depending on the extent and location of the defect. Demographic characteristics, injury mechanisms, defect locations, and surgical details were recorded. Postoperative complications and functional outcomes were assessed using fingertip-to-palm distance, Quick DASH score, and VAS for pain. Results Fourteen patients with severe hand injuries were included in the study. The mean age was 39.4 years, and the mean follow-up period was 19.7 months. Five patients with complex, multi-site defects underwent combined reconstruction using a PIA flap with local flaps (four with fillet flaps, one with a rotational flap), while nine patients were treated with an isolated PIA flap. Successful soft-tissue coverage was achieved in all patients without total flap loss. Partial distal flap necrosis occurred in two patients due to venous congestion and was managed with wound care followed by split-thickness skin grafting. At final follow-up, the mean fingertip-to-palm distance was 2.07 cm, the mean Quick DASH score was 21.89, and the mean VAS pain score was 2.07. All patients achieved stable wound healing and were able to perform daily activities without the need for further reconstructive procedures. Conclusion The PIA flap, either alone or in combination with local flaps, provides reliable soft-tissue coverage and favorable functional outcomes in patients with severe hand injuries. Combined reconstruction strategies should be considered based on defect characteristics, with acceptable complication rates and good functional recovery. This technique represents a valuable option in complex hand trauma reconstruction. Level of evidence IV © 2026 Elsevier Ltd.
dc.identifier.doi10.1016/j.injury.2026.113151
dc.identifier.issn0020-1383
dc.identifier.scopus2-s2.0-105032909806
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1016/j.injury.2026.113151
dc.identifier.urihttps://hdl.handle.net/11616/108011
dc.indekslendigikaynakScopus
dc.language.isoen
dc.publisherElsevier Ltd
dc.relation.ispartofInjury
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_Scopus_20250329
dc.subjectCombined
dc.subjectPosterior interosseous artery flap
dc.subjectReconstruction
dc.subjectRegional flap
dc.subjectSevere hand injury
dc.titlePosterior interosseous artery flap for severe hand injuries: Outcomes of reconstruction combined with local and regional flaps
dc.typeArticle

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