Posterior interosseous artery pedicle flap: an anatomical study of the relationship between the posterior interosseous nerve and artery

The anatomical relationships of the posterior interosseous artery and nerve are not well described. To characterize these relationships, ten cadaveric forearms were dissected and the relationships between the posterior interosseous nerve, its branches, and the posterior interosseous artery documented. The dissection of the posterior interosseous artery flap can be conceptualized in three zones with decreasing risk to the nerve as the dissection proceeds from proximal to distal. Provided fine motor branches of the posterior interosseous nerve are protected during the dissection of the nerve and artery, this flap can be harvested with safety.