Clinical Experience With Free Anterior Interosseous Flaps

Despite versatility of the forearm as a flap source, anterior interosseous flaps from the dorsal forearm has not gained popularity among other alternatives. In our clinical experience, we investigated the feasibility of free anterior interosseous flap as a donor site. Between January 2002 and January 2006, 10 free anterior interosseous flaps were used in 10 consecutive cases. Five flaps were used for coverage of the defects of the hand and fingers, whereas another 5 flaps were used for head and neck defects. In all cases, this flap was selected when a thin flap was needed. All flaps survived completely except 1, where partial marginal necrosis was seen, and this necrosis was healed by secondary intention. Only 2 donor sites could be closed directly, and the others were skin grafted. Free anterior interosseous flap is a useful alternative with distinct advantages: it is a thin flap, major extremity arteries are preserved, the vascular pedicle is long enough and caliber is satisfactory for microsurgery, composite flaps with tendon, bone, nerve, and muscle are available, and it has a good texture, especially for hand defects. The 2 major disadvantages are visible donor area scar and technically demanding dissection. In conclusion, free anterior interosseous flaps are a good selection and should be in the armamentarium of a microsurgeon, when a thin flap is needed for hand and head and neck reconstruction.