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Using retrograde island flap with dorsal interosseous artery to repair soft tiss ue defect of hands.

Since the report of retrograde island flap with radial artery by Lu and Wang in 1982 and retrograde island flap with ulnar artery by Li in 1984, the flaps from forearm has been commonly used clinically in recent years because of its good textrue and satisfactory therapeutic results. However, whether the function of hand will be impaired by cutting one of the main arteries which supply the hand still remains controversial. There has been an acute ischemia of hand reported in foreign literature. Since 1985 we have studied 50 upper limbs from fresh cadavers by arteriograghy and vascular dye infusion in our hospital. Based on the results that the distal end of the dorsal interosseous artery of forearm can be anastomosed with a number of dorsal branches of volar interosseous artery at the back of the wrist, we have designed a retrograde island flap with these anastomotic branches as its pedicle to repair soft tissue defect of hands and applied in 71 cases. Seventy flaps survived, only one underwent necrosis because of vascular deformity. It is concluded that the flap has many advantages such as good texture, easiness of anatomical operation and high survival rate. What is more, the flap can be transplanted with nerve, muscle tendon and ulner artery without damage to the main artery of forearm.