Clinical application of modified infrared thermal imaging assisted design of peroneal artery perforator propeller flap / 中华显微外科杂志

Objective:To explore the clinical value of modified infrared thermal imaging assisted design of peroneal artery perforator propeller flap.Methods:From March 2019 to May 2021, tourniquet-reperfusion augmented thermal imaging method (TRATIM) was used to locate the perforating vessels in 14 patients for surgery or peroneal artery perforator propeller flap. The sensitivity, positive predictive value and detection time were calculated and compared with the perforating vessels located by color Doppler ultrasound(CDU), P<0.05 is statistially significant. Results:After operation, 13 flaps survived completely, but 1 flap with distal surface necrosis and healed after dressing change. Only one linear scar was left in 12 cases, and 2 cases healed well by skin grafts. Followed-up for 6-13 months, and showed that the colour and texture of the flaps were similar to the surrounding skin, without obvious swelling. The sensitivity of TRATIM and CDU in location of peral perforator vessels were 88.0% and 92.0%, respectively, and the positive predictive value was 93.6% and 95.8%, with no statistical difference between TRATIM and CDU( P>0.05). The time of positioning perforator was (3.71±0.80) min for TRATIM and(16.21±4.97) min for CDU, There was significant difference between TRATIM and CDU( P<0.01). Conclusion:With TRATIM, a surgeon can locate the peroneal perforator vessels simply, quickly and accurately, and help in design more accurate peroneal artery perforator propeller flap.

Reconstruction of degree V defect of thumb: A case report / 中华显微外科杂志

In March 2014, a degree V defect of right thumb was reconstructed with a free right hallux nail flap combined with bone and tendon composite tissue of the 2nd toe in the Department of Hand Surgery, Ningbo No. 6 Hospital. A freed right superficial iliac circumflex artery perforator flap (SCIPF) and autologous iliac bone were used to repair the donor site of foot. The hand function was evaluated according to the upper limb function scoring system. Seven years after operation, the function of the right hand was significantly improved and the function of right foot was not significantly affected. According to the Michigan Hand Function Score, the result was 80 point. Functional recovery evaluated according to the Evaluation Standard of Reconstructed Thumb and Finger Functional of Hand Surgery of Chinese Medical Association, the result was excellent (14 point).

Reconstruction of 4 digits with defect of 10 digits: A case report / 中华显微外科杂志

A patient recovered partial hand functions by 4 reconstructed digits based on a pair of complete defect hands that lost all of 10 digits on March, 2014. The thumbs were reconstructed with bipedal nail flaps combined with iliac bone, the right index finger and left middle finger were reconstructed with the 2nd toes of feet. Bilateral superficial circumflex iliac artery rerforator flaps (SCIPF) were taken to repair the donor areas of feet. According to the DASH-Chinese upper limb function score system, the function of both hands was obviously improved in six and a half years after surgery. The function of both feet was not significantly affected.

Transfer of vascular pedicled free medial femoral condyle bone flap in treatment of scaphoid nonunion / 中华显微外科杂志

Objective:To investigate the clinical effect of the free medial femoral condylar bone flap in treatment of scaphoid nonunion.Methods:From May, 2012 to May, 2016, 15 patients, which were 10 males and 5 females and aged from 18 to 63 (mean 43.5±15.5) years, with scaphoid nonunion were treated with transfer of free medial femoral condyle bone flaps. After debridement of the fractural segment in surgery, the bone flap was transferred to scaphoid and had the bone defect filled. The artery of the bone flap was end-to-side or end-to-end anastomosed to the radial artery. The concomitant vein of the bone flap was end-to-end anastomosed to the concomitant vein of the radial artery. Thirteen patients were treated with the free osteoperiosteal medial femoral condylar graft, and 2 were treated with the free osteochondral medial femoral condylar graft. Fracture healing was evaluated based on X-ray evidence. The clinical effect was evaluated by visual analogue scale (VAS), strength of grip and modified Mayo wrist score. The t-test was used to compare the function between before and after surgery. Results:All patients were entered into a followed-up for an average of 32.5 (8-60) months, 11 of them took the follow-up reviews at the outpatient clinic and 4 via WeChat distanced interviews. All fractures of the 15 patients healed with an average healing time at 12.5 (10-16) weeks. The VAS score decreased from (3.5±1.5) before the surgery to (1.0±1.0) after the surgery. The strength of grip increased from (16.5±4.3) kg before the surgery to (31.5±3.5) kg at the last follow-up review. The modified Mayo wrist score increased from (46.2 ±11.4) before the surgery to (68.5 ±10.8) at the last follow-up review. The wrist function was excellent in 8 patients, good in 6 and fair in 1. There was significant difference in functional evaluation ( P<0.05). Conclusion:The transfer of free medial femoral condylar bone flap is effective in the treatment of scaphoid nonunion. This technique provides both of sufficient blood supply and a structural support for defected scaphoid bone and promotes the healing of fracture. Osteochondral flap transfer may be used as an alternative measure to prevent wrist osteoarthritis and collapse, in the case that there is an avascular necrosis of the proximal pole of the scaphoid. It has an advantage in the treatment of refractory scaphoid nonunion.

Free basilic vein flap with sensory nerve for repair of pulp defect of digits / 中华显微外科杂志

Objective:To investigate the effect of free basilic vein flap with sensory nerve in repair of digit pulp defect.Methods:From August, 2017 to December, 2020, 26 thumb and finger pulp defects were repaired with free basilic vein flap with sensory nerve. There were 23 defects of digit pulp, and 3 combined with dorsal soft tissue defect. The sizes of defect area of 11 thumbs and 15 fingers were 3.0 cm×2.0 cm-5.0 cm×3.5 cm. The size of flap was 3.5 cm×2.5 cm-5.5 cm×4.5 cm. All of the digit defects were repaired with free basilic vein flap carrying sensory nerve at the medial side of proximal forearm. All donor sites at forearm were directly sutured. All patients entered follow-up by clinic visit by telephone appointment. The appearance of the flaps was good with satisfactory texture, good pinching and well recovered sensation.Results:All 26 flaps survived in the 3-28 months(13 months in average) of follow-up. The TPD was 6-8 mm (6.8 mm in average). Only linear scars left at the donor sites without obvious discomfort, except 3 cases having in minor bloating. The bloated flaps were repaired 3 months after the primary surgery, and achieved more satisfactory appearances.Conclusion:Free basilic vein flap with sensory nerve is an ideal method to repair defect of digit pulp, especially in the digit pulp composite tissue defect combined with vessel and nerve defect.

Ulnar shortening oblique osteotomy combined with arthroscopy technique for ulnar impaction syndrome / 中华骨科杂志

Objective:To introduce ulnar shortening oblique osteotomy combined with arthroscopy technique for ulnar impaction syndrome and to evaluate the outcomes.Methods:From August 2012 to January 2015, data of 25 cases with ulnar impaction syndrome who were treated in our hospital with oblique osteotomy of the ulna and internal fixation were retrospectively analyzed. There were 14 males and 11 females with an average age of 32.5±4.9 years old (range, 18-62 years). All 25 cases had wrist triangular fibrocartilage complex (TFCC) injuries. Intraoperative arthroscopy was conducted to investigate the pathologic changes of the articular disk of the triangular fibrocartilage complex (TFCC), chondromalacia of the lunate and triquetrum, and tears of the lunotriquetral interosseous ligament (LTIL), debridement of the synovial membrane and the free edge of the central perforation of TFCC, to remove the cartilage from the lunate and triangular bone, and to perform oblique osteotomy of the ulna and internal fixation after repairing of TFCC ulnar tear. We evaluated the outcomes by means of comparing the postoperative values of modified Mayo and visual analogue scale (VAS).Results:There were 5 cases of IB, 5 of IIA, 7 of IIB, 4 of IIC, 4 of IID according to Palmer's classification. All 25 cases were followed-up for 24.6±1.9 months (range, 12-46 months). All patients achieved bone healing with an average of 14.0±1.9 weeks (range, 12-20 weeks). The mean value of preoperative ulnar variation was 3.8 ±1.5 mm which decreased to -1.5±0.5 mm after operation. The preoperative VAS was 7.8±0.7 which decreased to 1.3±1.5 at the latest follow-up. The modified Mayo value increased from 52.8±15.8 to 83.0±11.2. There were 19 cases with excellent wrist function, 5 good and 1 fair. The excellent-good rate was 96% (24/25). Grip strength value increased from 6.3±1.5 kg preoperative to 12.3±1.9 kg postoperative. There was no postoperative infection, delayed or nonunion of bone, but irritation of steel plate appeared in 10 patients, which disappeared after the removal of the steel plate.Conclusion:Arthroscopy combined with ulnar shortening oblique osteotomy technique for ulnar impaction syndrome can reduce wrist pain, increase hand grip strength, improve the activity of the wrist joint, and the clinical effect is positive.

Mechanism of RhoA in malignant tumors / 国际肿瘤学杂志

As a representative member of the Rho family,RhoA plays an important role in the onco-genesis and development of malignant tumors. According to previous studies,RhoA functions as a key regulator in mediating actin polymerization,cytoskeletal structure remodeling,cell polarity changes,epithelial-mesenchy-mal transition and so on. RhoA can promote multiple malignant phenotypes of tumor cells,such as migration, invasion,etc. At present,mainstream research believes that RhoA functions as oncogene in the carcinogenesis of tumors. Downregulated RhoA can inhibit tumor growth and progression,which can be used as a potential tar-get for clinical anti-tumor therapy.

The clinical results of free hypothenar perforator flap based on different sources of blood vessels transfer in the treatment of skin defects of the finger / 中华整形外科杂志

Objective@#To evaluate the outcome of free hypothenar perforator flap, with different vascular perforators, in fingerskin defects repairment.@*Methods@#From April 2014 to September 2016, 15 cases of skin defects on finger were treated with hypothenar perforator flap, based on different vascular perforators.Patients had nerves, vessels, tendons or bone exposure.Defects ranged from 1.5 cm×3.5 cm to 2.0 cm×4.5 cm in size. Fivecases were treated with hypothenar perforator flap based on a cutaneous perforator branch of the ulnar artery, 8 cases were based on acutaneous perforator branch of the ulnar digital artery, 2 cases were based on branch of the superficial volar arch.Donor site was closed directly.@*Results@#Vascular crisis occurred in 3 cases postoperatively, which were rescued by propertreatment. Other 12 transferred free flaps survived uneventfully.After averaged 13.5-month postoperative follow-up (ranging from 3 to 24 months), the appearance of transferred flaps was satisfactory. Flap texture was good with no obvious atrophy. All the fingers had good function.The sensation of flaps recovered to S3, and two-point discrimination was 8-9 mm. The donor site was healed with linear scar.@*Conclusions@#The hypothenar perforator free flap was relatively easy to practice.Constant vascular anatomy, the appearance, texture and good functional recovery after hypothenar free flap transferring, suggest this is achoice for repairing small skin defects on finger.

Mechanism of RhoA in malignant tumors / 国际肿瘤学杂志

As a representative member of the Rho family, RhoA plays an important role in the oncogenesis and development of malignant tumors. According to previous studies, RhoA functions as a key regulator in mediating actin polymerization, cytoskeletal structure remodeling, cell polarity changes, epithelial-mesenchymal transition and so on. RhoA can promote multiple malignant phenotypes of tumor cells, such as migration, invasion, etc. At present, mainstream research believes that RhoA functions as oncogene in the carcinogenesis of tumors. Downregulated RhoA can inhibit tumor growth and progression, which can be used as a potential target for clinical anti-tumor therapy.

Transposition of extensor retinaculum to reconstruct distal radioulnar joint dorsal ligament for treatment of distal radioulnar joint dorsal instability / 中华骨科杂志

Objective To evaluate the efficacy of distal radioulnar joint (DRUJ) dorsal ligament reconstruction using extensor retinaculum transposition with triagular fibrocartilage complex (TFCC) repair and dorsal capsuloplasty for chronic DRUJ dorsal instability.Methods From October 2007 to July 2016,data of 18 patients (11 men and 7 women with a mean age of 37.4 years) were retrospectively analyzed who underwent DRUJ dorsal ligament reconstruction with extensor retinaculum transposition,DRUJ dorsal capsuloplasty,and TFCC repair for DRUJ dorsal instability.The tissue flap of extensor retinaculum was fixed at the ulnar edge of distal radius by two micro anchors after TFCC repair and dorsal capsuloplasty of the DRUJ capsule.X-ray examination of wrist was performed for all the patients after operation to identify the reduction of DRUJ.The wrist range of flexion and extension,the forearm range of rotation,and the grip strength of hand were measured.Modified Mayo wrist scores,DASH scores and visual analogue scale (VAS) were used to evaluate the function and pain of wrist and upper extremity.Results 18 patients were followed up for 12-70 months with an average period of 34 months.The stability of the DRUJ was restored in 16 patients.The other 2 cases wore long arm splint for 6 weeks after operation due to the residual instability of the DRUJ,after that the instability of DURJ were improved to grade I.The flexion and extension of wrist,the rotation of forearm were improved,but there were no significant difference comparing to those of pre-operation.The VAS,modified Mayo and DASH scores,grip strength of hand were significantly improved from preoperative 4.2±1.1,67.4±11.2,51.3±14.2,16.3±3.7 kg to postoperative 0.2±0.5,83.9±11.6,15.9±3.2,24.9±6.4 kg at the latest follow-up.Conclusion Extensor retinaculum transposition with TFCC repair and DRUJ dorsal capsuloplasty can effectively relieve pain and recovery stability of DRUJ,which was an effective method for chronic DRUJ dorsal instability.

Reconstruction of the soft tissue defects of limbs using the free thoracodorsal artery perforator flaps / 中华显微外科杂志

Objective To investigate the clinical effects of reparing the complicated soft tissue defects of limbs with free thoracodorsal artery perforator (TDAP) flaps.Methods From April,2009 to March,2014,19 limbs (including 8 upper limbs and 11 lower limbs) soft tissue defects with bone and tendon exposure were repaired with free TDAP flaps in the secondary stage.There were 12 thoracodorsal artery perforator flaps,5 polyfoliate perforator flaps,1 chimeric muscle flap,and 1 chimeric muscle polyfoliate flap.The sizes of the flaps ranged from 5.0 cm×6.0cm-20.0 cm×l 1.0 cm.Seventeen wounds of the dornor site were closed directly,and the other 2 were closed with skin grafts.Results Sixteen flaps survived successfully.Two flaps had venous congestion and survived at last after taking the stitches out.One flap had partial necrosis and repaired by skin graft finally.The clinical results were satisfactory after 12-18 months following-up,and the scars of the dornor sites of all but 3 patients were not obvious.All the shoulder function were normal.Conclusion The TDAP flap has dependable blood supply,good texture,less dornor site morbility.The polyfoliate TDAP flap can be used for repairing irregular defect.The chimeric latissimus TDAP flap can be used for the function reconstruction.The free TDAP flap is suited for repairing soft tissue defects of the limbs.

Reconstruction of adjacent large finger pulps with the modified sensate free proximal ulnar artery perforator flap / 中华显微外科杂志

Objective To study the surgical techniques and the clinical curative ettect of the reconstruction of adjacent large finger pulps with the modified sensate free proximal ulnar artery perforator flap.Methods From February,2013 to May,2016,20 fingers in 10 patients with adjacent large finger pulp defects crossing the DIP joint were reconstructed by the modified senate free proximal ulnar artery perforator flap.All the pulps of every patient were recovered by 1 flap in the first stage and the artificial syndactyly of two digits was divided in 7 weeks after the flap transfer in the second stage.In order to reconstruct the sensation of two pulps in each patient,firstly both of the proximal and distal ends of the cutaneous nerve in flaps were dissected and anastomosed with the most lateral and medial palmar digital nerves of two adjacent fingers respectively,which were divided into 2 groups.Secondly the cutaneous nerve in the middle part of flap was cut and the two ends were anastomosed with the other two palmar digital nerves in the second surgery.There were 8 fingers in 4 patients with the index and middle finger pulp defects,12 fingers in 6 patients with the middle and ring finger defects.The flap size was from 5.0 cm×3.5 cm to 5.5 cm×4.0 cm,and the perforator artery was anastomosed with the palmar digital artery in 6 cases and with the joint branch of digital artery in 4 cases.Results Nine flaps survived uneventfully except the venous congestion was found in 1 flap which was salvaged successfully by acupuncture bleeding.Also,no congestion or ischemia of all the 20 pulp flaps occurred right after releasing the artificial syndactyly.The time of followed-up was from 11 months to 32 months with the average of 17 months after the second surgery.The static two point discrimination of the 2 groups of the sensate pulp flap was (7.3 ± 1.2) mm and (8.6 ±2.4) mm respectively.There was no significant difference between groups (P ＞ 0.05).These 20 pulp flaps were also assessed by the Semmes-Weinstein monofilament test with the result of diminished light touch in 14 pulps and diminished protective touch in 6 pulps.The total active motion in all 20 fingers was (248.0±4.5) °.No patients suffered cold intolerance and local pain but 1 had hypersensitiveness in the pulp flap.Conclusion The modified sensate free proximal ulnar arte~ perforator flap is a practical alternative for the reconstruction of two large adjacent pulps with satisfactory functional and aesthetic outcomes.

Repairing donor site of foot after improved toe-to-thumb reconstruction utilizing superficial circumflex iliac artery perforator chimeric flap / 中华显微外科杂志

Objective To evaluate the clinical outcome of the method of repairing donor site of foot after improved toe-to-thumb reconstruction utilizing superficial circumflex iliac artery perforator (SCIAP) chimeric flap.Methods Fourteen cases of thumb defect were recruited from April,2012 to January,2016.According to Gu Yudong's classification,5 cases met the criterion of type Ⅰ,4 cases met the criterion of type Ⅱ,and 5 cases met the criterion of type Ⅲ.For type Ⅰ,the thumb was reconstructed with the great toe wrap-around flap.For type Ⅱ and Ⅲ,the thumb was reconstructed by the combined tissue with mutual artery (great toe wrap-around flap,and the bonetendon tissue of the second toe).All the donor sites of foot were repaired utilizing SCIAP chimeric flap.Results All the reconstructed thumbs survived.Among 14 free flaps of donor site,1 case suffered venous crisis and survived after exploration and rescue surgery.Dorsal skin necrosis of the second toe was found in 1 case,which was healed by local skin flap transposition.All patients were followed-up ranged from 3 to 30 months (averaged at 16 months).In spite of slightly bloated,the color and texture of all the flaps' was satisfied,and the average healing time of the bone in the donor sites was 2.5 months.All patients did not feel painful and had no adverse effect when walking and running.Three months after the operation,5 slightly bloated flaps in the donor sites under went flap plastic and achieved better appearance.On the part of iliaca,there was only one inconspicuous linear scar without any discomfort.Conclusion Repairing donor site of foot after improved toe-to-thumb reconstruction utilizing SCIAP chimeric flap was an ideal method.Using this method,the reconstructed thumb can achieve good appearance and function,all the toes of donor site were reserved,and the disability of the donor site is minimized.

Transplantation of free proximal interphalangeal joint of the second toe with toe preservation for repair of traumatic digital arthritis / 中华创伤杂志

Objective To evaluate the clinical outcome of reconstruction of traumatic digital arthritis by transfer of free proximal interphalangeal joint of the second toe with toe reserving technique.Methods The study enrolled nineteen patients with traumatic digital arthritis treated from May 2013 to April 2016.The patients consisted of fifteen males and four females,and mnean age was 27.3 years (range,18-52 years).Finger involved included index fingers in 10 patients,middle fingers in seven and ring fingers in two.The joint of digit was reconstructed by transplanting the proximal interphalangeal joint of the second toe with a monitoring flap,and bone defect of the second toe was repaired with autogenous iliac bone graft.Wound was closed directly in six patients and covered by island flap from the foot dorsurn in 13 patients.Evaluation indicators contained survival rate of the free joint and island flap,appearance and fracture healing of the finger and toe and mnotion of the proximal digital joint.Finger function was studied using the evaluation standard of upper limb function set up by hand surgery branch of Chinese Medical Association.Healing in the donor site,foot function and related complications were observed.Results All the free joint and island flap survived.Period of follow-up was 6-30 months (mean,14 months).The fractured finger healed at 2.5 months on average,and appearance of the finger was good.Flexion range of the proximal digital joint was 63 °-80° (mean,74°) and extension range was-20°--10° (mean,-14°).Finger function was excellent in eleven patients and good in eight patients,with the excellent-good rate of 100％.Hematoma of the dorsal region of the foot occurred in one patient and the cut healed well after taking out some stitches and drainage.All fractured toe healed at 2.6 months.Except that one patient had fracture malunion with minor outward inclination,all presented good appearance of the toe without influencing walking and running.On the part of iliac,there was only one inconspicuous linear scar without any discomfort.Conclusions Transfer of free proximal interphalangeal joint of the second toe with toe preservation restores the anatomy structure and function of the digital joint.Meantime,autogenous iliac bone grafting combined with island flap from the foot dorsum for coverage of donor site defect retains the toe length and reduces injury of the donor site.

A biomechanical study on torque resistance of distal radioulnar joint by extra-and intra-articular reconstruction / 中华骨科杂志

Objective To compare the torque resistance effect with different types of reconstruction of the distal radioulnar joint (DRUJ) dislocation,in order to explore biomechanical basis for clinical practice.Methods Six adult cadaver forearm were used,including 4 males and 2 females.The average death age was 64.9 years (range,36-78 years).Three were right side,3 were left side.The DRUJ dislocation model was made after the standardized resection of the palmar and dorsal DRUJ ligament.Clinic reconstruction methods of the DRUJ include trans-bone tunnel renconstruction (intra-articular reconstruction) and Looptie up reconstruction (extra-articular reconstruction).The mechanical properties as follows:torque velocity:5°/min,maximum torque angulation:90°,maximum torsion force:1 N· mm.Each limb was detected for the torque mechanic under four conditions:normal,DRUJ dislocation,intra-articular reconstruction and extra-articular reconstruction.Results Each limb was inspected for intact mechanic baseline and without the visual damage to the bone.The average pronation torque resistance on normal condition was (0.44±0.10) N·mm,(0.37±0.09) N·mm on DRUJ dislocation group,(0.45±0.09) N-mm on intra-articular reconstruction group,and (0.42±0.09) N·nun on extra-articular reconstruction group.Pronation torque resistance of DRUJ dislocation group was apparently lower than the normal group (t=2.043,P=-0.047).The pronation torque resistance reconstruction group had no significant difference with normal group.The average supination torque resistance on normal condition was (0.56±0.16) N·mm,while on DRUJ dislocation group was (0.42±0.11) N-mm,on intra-articular reconstruction group was (0.54±0.16) N·mm,on extra-articular reconstruction group was (0.51±0.13) N·mm.There were no apparent differences among four groups.Conclusion Both internal and external reconstruction could recover the rotation stability and normalize the torque resistance,without statistical difference.

Reconstruction of the skin and soft defects of hand and foot by free medial sural artery perforator flap / 中华显微外科杂志

ObjectiveTo evaluate the curative effect of reconstruction of the hand and foot defects with bones and tendons exposure using free medial sural artery perforator flap(MSAP). MethodsRadiographs of 2 cadavers injected with a modified lead oxide-gelatin mixture were digitally analyzed. Between April 2007 and December 2010, thirty-four patients with soft tissue defects in the distal limb were treated with the free MSAP flap transplantation. The sizes of the defect ranged 6 cm × 4 cm-13 cm × 8 cm, and the flaps ranged 7 cm× 5 cm-14 cm × 9 cm. These clinical cases included 25 hands and 9 feet, all of them with bones and tendons exposure.In these defects,twenty-two were clean,twelve got infections.In our cases, twenty-three flaps were nourished with single perforator vessel and else 11 with two;perforator vessel fifteen flaps were dissected one superficial vein to anastomose with that of the recipient sites in addition to accompanying vein anastomosis;The sensation of 9 flaps recovered the hands were reconstructed with cutaneous nerve anastomosis. ResultsA partition of the calf skin blood vessels,and three-dimensional reconstruction image of the sural artery were obtained.All flaps survived,five of them appeared partially violet and bubbles. Followed up 6-21 months, the cosmetic results were satisfactory and without apparent bulkiness.The flap colors were similar to recipient sites. The flap senses reconstructed with neural anastomosis recover to S2-S3. ConclusionThe new flap is very suitable to repair the soft tissue defect in the distal limbs,because the fairly constant perforator vessel,the reliable blood supply and the cosmetic shape of the MSAP flap are all advantages of it in addition to no damage to low leg chief artery and gastrocnemius.

An anatomic study of the dorsal forearm perforator flaps / 中华显微外科杂志

Objective To provide anatomical landmarks with which to facilitate flap dissection,we studied the perforator artery of the dorsal forearm including its source,quantity,origination,caliber,variation and pedicle length. Methods Ten fresh cadavers were injected with a modified lead oxide-gelatin mixture,and three-dimensional graphics of the perforator vessels of the dorsal forearm were reconstructed with a computed tomography. In addition, twenty upper extremity specimens were injected with red latex via the axillary artery.The integument of the forearm was dissected,and perforators were identified,including type,course,size and location were documented.Surface areas were measured with Scion Image. Results The average number of the posterior interosseous artery cutaneous perforators in the dorsal forearm was (5±2),the average outer diameter of the perforator artories was (0.5 ± 0.1) mm,and the pedicle length was (2.5 ±0.2) cm.The average cutaneous vascular territory was (22.0 ± 15.0) cm2.The dorsal branch of the anterior interosseous artery dispersed on the wrist dorsum or the distal third of the dorsal forearm. It's average diameter was 0.8 mum. Conclusion The free transplantation of the posterior interosseous perforator artery flaps or rotary flap pedicled by the dorsal branch of the anterior interosseous artery for defect reconstruction are feasible.