Sixteen patients with a posterior interosseous artery (PIA) forearm flap ar
e presented. Fourteen distally based fasciocutaneous PIA island flaps, one
distally based PIA fascial flap and one PIA free flap have been performed t
o cover defects of the dorsum of the hand (10), first web space (5) and low
er leg (1). The size of the island flaps ranged from 3 to 5 cm in width and
6 to 13 cm in length, The maximum size of skin island was 13x4 cm. The are
a of reach for the distally based PIA flap was the MP joint. Venous congest
ion with partial flap loss was seen in two cases, radial nerve palsy with a
n incomplete extension of the fourth and fifth finger in one case. The dono
r site was closed primarily most times. In the majority of cases the scarri
ng at the donor site was inconspicuous. There was practically no functional
loss. The flaps contoured well to the recipient site and had good texture
and color match.