Contribution of the anterior interosseous artery to the blood supply for posterior forearm region and applications in designing the posterior interosseous forearm flap

ABSTRACT

The anterior interosseous artery (AIA) plays an essential role in designing the posterior interosseous forearm flap (P.I.F.F). Understanding about anatomy of this artery permit us to find us to find out new solutions to design the P.I.F.F. in situations at which there are variations of the PIA. Objectives: (I) to evaluate the role of the anterior interosseous artery in the blood supplying to the posterior forearm region; (II) assessing the importance of anterior interosseous artery in designing the posterior interosseous forearm flap. Methods: 27 forearms of adults obove 25 years old, including 25 forearms fixed in formalin 4% and 2 fresh forearms, are objects for us to expose the AIA and PIA by different techniques. Results: There are 2-5 perforating branches of the AIA to the deep muscular layer of posterior. They connect to each other and to the muscular branch of the PIA, and their diameter becomes much larger in two cases of absence of the PIA. Branches from this series of arterial anastomoses distribute also to the skin of inferior half of posterior forearm. The posterior terminal branche of the AIA divides into the medial and recurrent branch. These two branches ascend and anastomose with the PIA and the muscular branch of the PIA, respectively. The medial branch of the posterior terminal branch is absent or disconnected with the PIA at two other cases. Conclusion: Our results indicate that the AiA supplies the inferior half and the deep muscular layer of the posterior forearm. The posterior interosseous forearm flap can still be raised in situations at which the posterior terminal branch of AIA communicates with the dorsal carpal arcus but not with the PIA and the PIA is absent.