Ulnar Side Hand Coverage Using the Posterior Interosseous Flap: Recent Advances and Perspectives in Reconstructive Surgery

Abstract: Soft tissue defects of the ulnar aspect of the hand present a significant challenge in reconstructive surgery due to the anatomical complexity and essential functional roles of this region, particularly in grip and sensation. The posterior interosseous flap (PIF) is a reliable option for covering such defects, especially when deep structures such as tendons or nerves are exposed. This pedicled flap, based on the posterior interosseous artery, allows high-quality coverage while preserving the major vascular axes of the forearm. We report a case of reconstruction of the ulnar side of the hand using the posterior interosseous flap, with a detailed description of the surgical technique, postoperative course, and outcomes. This case highlights the value of this flap in managing localized cutaneous defects of the hand, combining ease of execution, vascular reliability, and satisfactory functional results.