ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicInnovations in Upper Limb Reconstruction and ProstheticsView all articles
Posterior interosseous artery perforator propeller flap for the 1 repair of wrist and hand dorsal wounds 2
Provisionally accepted
- 1First Affiliated Hospital, Guangxi Medical University, Nanning, China
- 2The Second Affiliated Hospital of Guilin Medical University, Guilin, China
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Abstract 19 Objective: To evaluate the clinical efficacy of the posterior interosseous artery (PIA) 20 perforator propeller flap for repairing dorsal wounds of the wrist and hand. Methods: 21 From October 2018 to October 2022, 12 patients with dorsal defects of the wrist (n=5) 22 or hand (n=7) underwent repair using the PIA perforator flap. Surgical technique 23 involved preoperative Doppler ultrasound localization of perforators, flap design 24 centered on the selected perforator, and flap rotation within 180° to cover the defect. 25 Surgical outcomes were assessed based on flap survival, complications, and changes in 26 preoperative/postoperative Visual Analogue Scale (VAS) scores and Disability of the 27 Arm, Shoulder, and Hand (DASH) scores. Results: 12 cases of skin flaps were 28 successfully harvested, and the donor sites were directly sutured. Postoperatively, 11 29 flaps survived completely, one case developed wound infection, which resolved with 30 debridement and dressing changes. Patients were followed for 6 to 18 months (mean 12 31 months). Flap texture and appearance were satisfactory with no significant swelling. 32 Patient satisfaction reached 91.67%. At final follow-up, DASH scores ranged from 2 to 33 15, with a mean of 9.2. Mild scar hyperplasia was observed in the donor site in 2 cases 90 and at the flap margin in 1 case. Conclusion: For repairing soft tissue defects on the 91 dorsal wrist, the interosseous posterior artery perforator flap offers valuable and reliable 92 clinical application due to its vascular constancy, preservation of major vessels, 93 minimal surgical complexity, favorable aesthetic and tactile qualities, minimal donor 94 site trauma, and high flap survival rate.
Keywords: dorsal of hand, dorsal of wrist, Perforator propeller flap, posterior interosseous artery, soft tissue defect
Received: 12 Jan 2026; Accepted: 03 Feb 2026.
Copyright: © 2026 Jian, Tang, Xie, Lv, Li, Bin, Ye, Su and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yongfeng Su
Jianwen Cheng
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