A 24-year-old male who suffered a severe crush injury in his left upper limb.
After initial care, the patient presents exposure of the osteosynthetic plaque in the distal third of the radius and thrombosis of the revascularization anastomosis at the radial and ulnar level.
The absence of reverse flow in the posterior interosseous artery was confirmed by Doppler ultrasound.
After debridement, a radioulnar bypass was performed with saphenous vein graft for limb revascularization.
As a means of covering the osteosynthesis material and the distal anastomosis of the by-pass, a flap of the posterior perforating forearm was proposed interosseous of 15x7.5 cm on the dorsal face.
The skin perforator was 4 cm proximal to the distal joint.
Once the flap could be pivotted in the cutaneous perforating vessels of the posterior interosseous artery, it was rotated 90 degrees through the ulnar edge of the forearm until reaching the volar face.
The donor site was covered with a partial skin graft.
