Surg Radiol Anat (1986) 8 : 209-215
Radiologlc
Anatomical bases of medical, radiological and surgical techniques
The anatomic basis of the fascio-cutaneous flap
of the posterior interosseous artery
CV Penteado 1, AC Masquelet 2 and JP Chevrel 3
1 Anatomy Department, Institute of Biology, State University of Campinas, S. Paulo, Brazil (Study grant FAPESP No. 85/0667-3)
2 H6pital Trousseau, Service d'Orthopddie Pddiatrique, 26, av. Dr Aruold-Netter, 75571 Paris Cedex 12, France
3 Laboratoire d'Anatomie et Chirurgie Exp6rimentale, Facult6 de M6decine, Paris XIII, 74, rue Marcel-Cachin, 93000 Bobigny, France
Summary. The authors present a study of the surgical
anatomy of the posterior interosseous artery (PIA) in
70 cases to establish the anatomic basis of a new
forearm fascio-cutaneous flap, the posterior interosseous
flap which has been described by one of the authors (AC
Masquelet). The PIA was verified in every case. Its
course corresponds to a line drawn from the lateral
epicondyle of the humerus to the head of the ulna, i.e. to
the septum between the extensor carpi ulnaris and
extensor digiti minimi proprius muscles. The artery,
whose average caliber is 1.7 ram, gives off 7 to 14
cutaneous branches in its course. The point of emer-
gence of the artery in the posterior aspect of the forearm
corresponds to the junction between the upper and
middle thirds of the line from the epicondyle and the
ulnar head. The PIA anastomoses with the anterior
interosseous artery and the dorsal carpal network in
98.6 % of cases. The artery remains closely related to
the deep branch of the radial nerve and is crossed by the
branches of this nerve to the extensor carpi ulnaris
muscle. The cutaneous distribution of the PIA extends
from elbow to wrist, centered on the epicondylarulnar
line, with an average breadth of 5 cm. Twelve opera-
tions have already been performed using the posterior
interosseous flap, 2 with a direct pedicle and 10 with a
retrograde pedicle, and all survived completely.
Les bases anatomiques du lambeau septo-cutan6
de l'art~re interosseuse post6rieure
Summary. Les auteurs font une 6tude anatomo-chirur-
gicale de l'art6re interosseuse postdrieure (AIP) sur
Offprint requests : CV Penteado
Surgical 2
Anatomy
9 Springer-Verlag 1986
70 cas, pour 6tablir les bases anatomiques d'un nouveau
lambeau septo-cutan6 de l'avant-bras : le lambeau inter-
osseux post6rieur mis au point par l'un des auteurs (AC
Masquelet). L ' A I P a 6t6 constat6e dans tousles cas. Son
trajet peut ~tre figur6 par une ligne qui va de l'6pi-
condyle latdral (epicondylus lateralis) 5 la tate de l'ulna
(caput ulnae) et qui correspond au septum entre les
muscles extenseur ulnaire du carpe (extensor carpi
ulnaris) et extenseur du petit doigt (extensor digiti
minimi). L'art~re, qui a un calibre moyen de 1,6 ram,
d61ivre, dans son trajet, de 7 fi 14 branches cutan6es. Le
point d'dmergence de l'art6re dans ]a face post6rieure de
l'avant-bras correspond au point d'union entre le tiers
supdrieur et le tiers moyen de la distance 6picondyle
latdral-tate de l'ulna. L ' A I P s'anastomose avec l'art6re
interosseuse antdrieure (a. interossea anterior) et le
rdseau dorsal du carpe (rete carpi dorsale) dans 98,57 %
des cas. L ' A I P maintient des rapports tr6s 6troits avec la
branche profonde (ramus profundus) du neff radial (n.
radialis) et est croisde par la branche que ce nerf fournit
au muscle extenseur ulnaire du carpe. Le territoire
cutan6 de I'AIP va du coude jusqu'au poignet, avec une
largeur moyenne de 5 cm, centr6e sur la ligne
6picondyle lat6ral/t~te de l'ulna. Douze cas cliniques ont
6t6 ddjfi r6alis6s en utilisant le lambeau interosseux
postdrieur, 2 fi p6dicule direct et 10 ~ pddicule
r6trograde. T o u s l e s lambeaux ont surv6cu en totalit6.
Key words : Gross anatomy - Posterior interosseous
artery - Forearm flap - Pedicled flap - Fascio-cutaneous
flap
210 CV Penteado et al. : Fascio-cutaneousflap of the posterior interosseous artery
For a number of years two types of cutaneous blood-
supply were recognized. The first or so-called axial type
consists of vessels, rather few in number, which traverse
the subcutaneous tissue over long distances, parallel to
the skin surface, and are often accompanied by venae
comitantes. This type of supply constitutes the anatomic
basis of several skin flaps (Taylor and Daniel 1975).
The second or musculocutaneous type of supply consists
of intramuscular subaponeurotic arteries which perforate
the aponeurosis and supply a very limited skin area.
Anastomoses between adjacent arteries are numerous.
This type of perforating musculocutaneous artery
constitutes the anatomic basis of musculocutaneous flaps
(McCraw et al 1977a, McCraw et al 1977b, McCraw
and Vasconez 1980).
Recent studies (Ponten 1981, Haertsch 1981, Ruyao
Song et al 1982, Gr6co et coll 1983, Cormack and
Lamberty 1984a) have demonstrated the existence of
skin supply by fascio-cutaneous arteries. These arteries
arise from the deep vessels, traverse the intermuscular
septa and form an abundant network at the level of the
apone.urosis from which branches are given off to supply
the skin. Systematic exploration of the intermuscular
septa has disclosed several regions where such arteries
exist and has opened the way to a description of a new
type of flap, the fascio-cutaneous flap (Ponten 1981,
Gr6co et coll 1983, Cormack and Lamberty 1984b). The
studies of Ponten (1981) and Haertsch (1981) have
demonstrated the importance of the aponeurosis in the
vascularization of the skin. Following the demonstration
of this type of blood-supply, numerous fascio-cutaneous
flaps have been described for both the upper and lower
limbs.
Among the forearm flaps, the "Chinese flap" des-
cribed by Yang Guofeng et al (1981) and popularized in
the west by Ruyao Song et al (1982) has been studied
and employed by numerous workers (M~hlbauer et al
1982, Soutar et al 1983, Biermer and Stock 1983,
Foucher et al 1984, Masquelet 1984, Groenevelt and
Schoorl 1985, Kevorkian et al 1985, Schools et al
1985). Following the reports of the Chinese flap, other
forearm fascio-cutaneous flaps have been described
(Lamberty and Cormack 1983).
In the present study we investigated the surgical
anatomy of the posterior interosseous artery to establish
the anatomic basis of a new forearm fascio-cutaneous
flap, the posterior interosseous flap (Masquelet and
Penteado 1986).
Material and methods
Our study was conducted on 35 nonembalmed subjects
of both sexes, aged from 62 to 98 years, dissected on
both sides (a total of 70 specimens) in the following
manner :
Injection of colored latex followed by dissection:
50 cases. The injection was made into the brachial
artery at the middle third of the upper arm after
dissection and catheterization of the artery, using 15 to
20 ml according to the size of subject. In the 10 last
cases we also injected the venae comitantes. The
dissection was done 24 hours at least after the latex
injection, following a definite routine.
Selective injection of the posterior interosseous
artery; I8 cases. After dissection and catheterization of
the PIA and ligature of the anterior interosseous artery at
its origin, we performed: injection of 5 ml of a 5%
solution of methylene blue: 10 cases; injection of 5 ml
of latex colored with indian ink, followed by removal
and diaphanization of the skin of the dorsal aspect of the
forearm: 2 cases; injection of latex and lead oxide (5 ml)
followed after 48 hours by removal and radiography of
the skin of the dorsal aspect of the forearm: 6 cases.
Injection of the brachial artery with latex and lead
oxide (18 ml) followed by radiography of the forearm in
frontal, lateral and oblique views: 2 cases.
Results
The posterior interosseous artery was located in all the
70 cases studied, and its origin was determined in every
case. In 63 cases (90%) the artery originated from the
common interosseous artery and in 7 cases (10%) from
the ulnar artery.
After its origin the artery passes between the chorda
obliqua and the interosseous membrane and enters the
posterior compartment of the forearm by passing
between the supinator and abductor pollicis longus
muscles. It then continues between the superficial and
deep muscle planes of the part.
After emerging on the posterior aspect of the
forearm, the artery divides into two branches: an
ascending branch running towards the elbow and giving
off several muscular and cutaneous branches, and a
descending branch, the interosseous artery properly
so-called, travelling between the extensor carpi ulnaris
and the extensor digiti minimi muscles. The course of
the artery corresponds to a line drawn from the lateral
humeral epicondyle to the head of the ulna (Fig. la), a
line corresponding to the septum between these two
muscles (Fig. lb). As this septum is oriented almost
frontally in its proximal half and sagitally in its distal
half, the artery is situated beneath the extensor digiti
minimi in its upper course and between the two muscles
more distally.
The average distance between the lateral epicondyle
and the point of emergence of the artery in the posterior
part of the forearm, measured in 70 cases, was 83 mm
CV Penteado et al. : Fascio-cutaneous flap of the posterior interosseous artery
(range 66 to 100 mm).This distance corresponds to
35.3% (range 30.6 to 40.8%) of the distance between
the lateral epicondyle and the head of the ulna. Thus, the
point of emergence of the artery in the posterior
compartment of the forearm corresponds approximately
to the junction between the upper and middle thirds of
the distance between lateral epicondyle and head of ulna
(Fig. 2).
The PIA gives off between seven of fourteen
cutaneous branches. These perforate the deep fascia of
the posterior compartment of the forearm along the
septum between the extensor carpi ulnaris and extensor
digiti minimi muscles (Fig. 3) and ramify in the skin of
the posterior aspect of the forearm (Fig. 4). There
normally exist two or three cutaneous branches arising
from the ascending branch and travelling partly in the
muscle masses around the elbow, but these are of no
surgical interest. In 41 cases out of 50 we found a
large-sized cutaneous branch at an average distance of
85 mm (range 51 to 114 ram) from the epicondyle, at a
point adjacent to that where the artery emerges in the
back of the forearm.
The anastomoses between the PIA, the anterior
interosseous artery and the dorsal carpal network were
located in 69 cases (98.6%). The anastomosis between
the two interosseous vessels is effected by a short branch
situated beneath the tendon of the extensor indicis
proprius at the level of the head of the ulna, a
well-known anastomosis described by the classic authors
(Fig. 5). The PIA gives off between 13 and 22 branches
to the muscles of the posterior compartment of the
forearm. It also gives off inconstant periosteal branches
solely to the head and neck of the ulna (Table 1).
After its emergence in the back of the forearm the
PIA has an average external caliber of 1.6 mm (range
0.9 to 2.7 ram), while the anastomotic branch to the
anterior interosseous artery has a caliber of 0.7 mm
(range 0.2 to 1.2 ram). The general arrangement of the
satellite veins of the PIA is very variable. In 3 cases we
found a solitary satellite vein; in 2 cases there were
2 satellite veins throughout the course of the artery and
in 5 cases we found 2 veins in the proximal portion of
the artery and only one in its distal part. The selective
injections with methylene blue showed that the skin
distribution of the PIA extends from elbow to wrist,
Table 1. Number of periostal branches to the ulna. 50 cases
Branches No. of cases
Head only l1
Neck only 6 several aspects of the anatomic study must be discussed.
Head and neck 14
Total branches to head 25
Total branches to neck 20
211
Table 2. Statistical analysis. Correlations
Correlations r n t p
Age • external caliber 0.17 50 1.20 0.05
Age • total no. of branches 0.02 50 0.14 0.05
Caliber x total branches 0.16 50 1.12 0.05
Skin br. x muscular br. 0.05 50 0.35 0.05
centered on the line between lateral epicondyle and head
of ulna and with an average breadth of 5 cm (Fig. 6).
Relations of the posterior interosseous artery
and the deep branch of the radial nerve
The deep branch of the radial nerve and its continuation
as the deep branch of the radial nerve is situated on the
lateral side of the posterior interosseous artery. The
nerve and its branches pass beneath the lateral branches
given off by the artery to the superficial regional
muscles (Fig. 7 ab). However, the branch of the radial
nerve to the extensor carpi ulnaris crosses the interos-
seous artery and becomes very closely related to it.
When the branch of the nerve to the extensor carpi
ulnaris arises at a higher level, before the emergence of
the artery on the back of the forearm, it crosses the
ascending branch of the artery.
In 4 cases out of 70 (5.7%) the artery, after its
emergence in the back of the forearm, gives off a large
number of branches in a radial direction and rapidly runs
out. In these cases we found that a large branch arising
from the anterior interosseous artery at the middle third
of the forearm perforated the interosseous membrane,
emerged in the back of the forearm and constituted the
distal half of the PIA. In 11 cases out of 50 (22%) we
noted the absence of the ascending branch; in 36 cases
(6%) there were two ascending branches.
Radiography of the forearm indicated that the lateral
view is best for visualization of the P1A. As the image
of the Ulna is partly superimposed on that of the artery in
this view, it is useful to eliminate the bone by
subtraction films (Fig. 8). Statistical analysis did not
show any valid correlations between the various quanti-
tative data of our study (Table 2).
Discussion
The anatomic study of the posterior interosseous artery
has stimulated the proposal of a new fascio-cutaneous
flap raised on the posterolateral aspect of the forearm.
Before proceeding to the clinical applications however,
The origin, course and general arrangement of the
PIA have given rise to descriptions analogous to our
own in previous accounts. Testut (1890), Dujarier
212 CV Penteado et al. : Fascio-cutaneous flap of the posterior interosseous artery
CV Penteado et al. : Fascio-cutaneou~ flap of the posterior interosseous artery 213

Fig. 2
The arrow indicates the point of emergence of the posterior
interosseous artery in the posterior compartment of the forearm. This
point approximately corresponds to the point of junction (+) between
the proximal and middle thirds of the distance between the lateral
epicondyle (le) and the ulnar head (hu)
La fl~che indique le point &Emergence de l'art~re interosseuse
postrrieure dans la face postrrieure de l'avant-bras. Ce point
correspond, approximativement, au point d'union (+) entre le tiers
proximal et le tiers moyen de la distance entre l'rpicondyle latrral (le)
et la t6te de l'ulna (hu)
Fig. 8
Radiograph of the forearm after injection of brachial artery with latex
and lead oxide to show the posterior interosseous artery u ulnar artery,
small arrow common interosseous artery large arrow anterior
interosseous artery paired arrows posterior interosseous artery a
anastomosis between the two interosseous arteries
Radiographie de l'avant-bras apr6s injection de l'art6re brachiale an
latex et oxyde de plomb pour montrer l'art6re interosseuse post6rieure
u a. ulnaire petite fl~che a. interosseuse commune grandefl~che art6re
interosseuse ant6rieure double fl~che art6re interosseuse postdrieure
a anastomose entre les deux interosseuses

(1905) and Rouvi6re and Delmas (1984) state that the
artery regularly divides into two branches; an ascending
branch known as the interosseous recurrent artery,
which engages in anastomoses with the posterior branch
of the profunda brachii, and a descending branch which
travels between the extensor carpi ulnaris and extensor
digiti minimi muscles and anastomoses with the anterior
interosseous artery and the dorsal carpal network.
Different publications make different statements as
to the anatomic variations. The great majority of authors
are agreed on tile constancy of the PIA. However,
Kenesi and Honnart (1968) found the descending branch
in only 22 out of 30 dissections. Morin et al (1969)
affirm, though without giving figures, that dissection of
the descending branch is difficult because of its small
size and rapid disappearance. Valdecasas-Huelin et al
(1978) confirm the constant presence of the PIA and its
two branches, but found its anastomosis with the

-.,11..--

Fig. 1, 3-7
la Line corresponding to course of posterior interosseous artery le lateral epicondyle, hu head of ulna lb septum between the two muscles 3 The
cutaneous branches of the posterior interosseous artery (arrowed) perforate the aponeurosis of the posterior aspect of the forearm along the septum
between the extensor carpi ulnaris (ecu) and extensor digiti minimi (edm) muscles 4 Diaphanization of the skin of the back of the forearm after
selective injection of the posterior interosseous artery with latex colored with indian ink to show the cutaneous branches anastomosing among
themselve LE lateral epicondyle, HU ulnar head 5 Anastomosis large (arrow) between the anterior (aia) and posterior (pia) interosseous arteries.
The anastomotic branches with the dorsal carpal network can be seen (small arrows) 6 Selective injection of the posterior interosseous artery with
methylene blue to show the skin territory it supplies le lateral epicondyle, hu ulnar head 7a The deep branches of the radial nerve (R) lies lateral to
the posterior interosseous artery (PIA) and beneath the branches (SB) given off by the artery to the superficial muscles of the region. The branch of
the nerve to the extensor carpi ulnaris muscle (arrowed) passes superficial to the artery 7b Diagram of the above (lettering as previsouly)
la Ligne qui correspond au trajet de l'art~re interosseuse postrrieure le 6picondyle latrral hu trte de l'ulna lb Le septum entre les denx muscles
3 Les branches cutanres de l'art~re interosseuse postrrieure perforent l'aponrvrose de la face postrrieure de l'avant-bras en suivant le septum entre
les muscles extenseur ulnaire du carpe (ecu) et extenseur du petit doigt (edm) 4 Diaphanisation de la peau de la face postrrieure de l'avant-bras,
apr~s injection srlective de l'art~re interosseuse postrrieure au latex color6 avec encre de Chine, pour montrer les branches cutanres qui
s'anastomosent entre elles le 6picondyle latfral hu trte de l'ulna 5 Anastomose (grosse flrche) entre les artrres interosseuses antrrieure (aia) et
postrrieure (pia). On peut voir les branches anastomotiques avec le rrseau dorsal du carpe (petites flbches) 6 Injection srlective de l'artrre
interosseuse postrrieure au bleu de mrthylrne pour montrer le territoire cutan6 d'irrigation le 6picondyle latrral hu t~te de l'ulna 7a la branche
profonde du neff radial (R) passe du crt6 latrral de l'artrre interosseuse postrrieure (PIA) et an-dessous des branches (B) que l'art~re foumit anx
muscles superficiels de ta rrgion. La hranche du nerf pour le muscle extenseur ulnaire du carpe (fl~ches) passe an-dessus de l'artrre 7b Schrma de
la photo (R, PIA, B et flrches comme en 7a)
214 CV Penteado et al. : Fascio-cutaneous flap of the posterior interosseous artery

ohU
9

/
10
Figs. 9-10
9 drawing of an interosseous flap with retrograde pedicle for covering
defects on the hand 10 drawing of a flap with direct pedicle for
covering defects at the elbow, le lateral epicondyle hu head of ulna Fig. 11
9 Sch6ma d'un lambeau ~t p6dicule rftrograde destin6 ~t couvrir les Posterior interosseous flap with retrograde pedicle a sequel of burn in
a child of 3 years: skin contracture on the dorsum of the wrist
pertes de substances de la main 10 Sch6ma d'un lambeau ?i p6dicule
previously treated by excision and fullthickness skin-graft b dissection
direct destin6 a couvrir les perte's de substance du coude, le 6picondyle
of posterior interosseous flap and covering of defect after excision of
lat6ral hu tdte de l'ulna
contracted skin e final results after healing
Lambeau interosseux postdrieur ~ p6dicule r6trograde a s6quelle de
bnalure chez un enfant de 3 ans. R6traction cutande de la face dorsale
du poignet ayant ddj~ fait l'objet d'une excision ant6rieure avec greffe
de peau totale b dissection du lambeau IOP et recouvrement de la perte
anterior interosseous artery in only 50% of their de substance apr6s r6section de la zone cutan6e r~tractile c r6sultat
dissections, nor do they report the existence of an final apr6s cicatrisation
anastomosis with the dorsal carpal plexus. In our o w n
study we found, in 5 out of 70 dissections, either the
disappearance of the descending branch at the middle
third of the forearm (4 cases) or absence altogether of
Moreover, in our series the ascending branch was found
anastomoses at the wrist (1 case).
to be absent in 11 cases out o f 50.
As for the cutaneous branches and the territory of the
PIA, we are in accord with the observations of S a l m o n
(1936) and M a n c h o t (1983). The skin territory occupies Clinical applications
a strip 5 c m wide extending from the lateral epicondyle
to the head of the ulna. The upper fourth of this zone is Thus, the cutaneous territory of the posterior interos-
not available in the design of a skin flap, as it depends seous artery can form the basis for the design of a
on the ascending branch of the PIA whose surgical pedicled skin flap. Such a flap m a y be used in two
dissection is made difficult b y its intramuscular course. ways:
CV Penteado et al. : Fascio-cutaneous flap of the posterior interosseous artery
With a direct pedicle, the flap being raised at the distal
third of the forearm and the pedicle being dissected up to
the emergence of the artery under the supinator muscle;
the length of pedicle allows an arc of rotation enabling
the flap to cover defects at the front of the elbow and at
the olecranon (Fig. 10)
With a retrograde pedicle: the flap is outlined opposite
the emergence of the artery at the junction of the upper
and middle thirds of the line joining the lateral
epicondyle to the head of the ulna, and the pedicle being
dissected as far as the head of the ulna. The arc of
rotation then allows application to the dorsal aspect of
the hand, the anterior aspect of the wrist and the first
web (Fig. 9). The venous return is effected entirely by
the venae comitantes. The deep branch of the radial
nerve is easily detachable from the vascular pedicle. The
only tricky phase of the dissection consists of recogni-
tion of the motor branch to the extensor carpi ulnaris,
and when the nerve crosses the artery it is preferable to
ligate the artery further down in the case of a flap with a
retrograde pedicle.
One variant of the posterior interosseous flap is its
use as a purely aponeurotic flap, only the aponeurosis
being raised after reflection of the skin and subcutaneous
areolar tissue en bloc. We have performed posterior
interosseous flaps in 12 clinical cases, 2 with a direct
pedicle and 10 with a retrograde pedicle, and all these
flaps survived in their entirety (Fig. 11).
Conclusion
Our anatomic study has shown the reliability of a skin
flap based on the posterior interosseous artery in the
forearm. Although of small size, this flap has the
advantage of not sacrificing a main vascular axis. In our
view, it deserves to be included in the range of
techniques for repair of defects in the upper limb.
References
1. Biermer R, Stock W (1983) Total thumb reconstruction: a one
stage reconstruction using an osteo-cutaneous forearm flap. Br J
Plast Surg 3 6 : 5 2 - 5 5
2. Cormack GC, Lamberty BGH (1984a) Fasciocutaneous vessel.
Their distribution on the trunk and limbs, and their clinical
application in tissue transfer. Anat Clin 6:121-131
3. Cormack GC, Lamberty BGH (1984b) A classification of
fasciocutaneous flaps according to their patterns of vasculari-
zation. Br J Plast Surg 37 : 80-87
4. Dujarier Ch (1905) Anatomie des membres. G Steinheil, Paris
215
5. Foucher G, Van Genechten F, Merle N, Michon J (1984) A
compound radial artery forearm flap in hand surgery : an original
modification of the chinese forearm flap. Br J Plast Surg 37 :
139-148
6. Greco JM, Simons G, Fangon H (1983) Une arme nouvelle en
chirurgie plastique: le lambeau cntanro-aponrvrotique. Son
application dans la reparation des pertes de substance du membre
infrrieur. Apropos de 10 observations. Ann Chir Plast Esthet 28 :
211-224
7. Groenevelt F, Schoorl R (1985) The reversed forearm flap using
scarred skin in hand reconstruction. Br J Plast Surg 38 : 398-402
8. Haertsch P (1981) The surgical plane in the leg. Br J Plast Surg
34 : 464-469
9. Kenesi C, Honnart F(1968) Les art&res interosseuses ~t l'avant-
bras. CR Assoc Anat 53 : 1057-1066
9bis. Kevorkian B, Legre R, Magalon G, Bureau H (1985) Le
lambeau antibrachial ~ prdicule radial. A p r o p o s de treize
observations (The forearm flap with a radial pedicule). Ann Chit
Plast Esther 30 : 121-126
10. Lamberty BGH, Cormack GC (1983) The antecubital fascio-
cutaneous flap. Br J Plast Surg 36 : 428-433
11. Manchot C (1983) The cutaneous arteries of the human body.
Springer, New York
12. Masquelet AC (1984) Anatomy of the radial forearm flap. Anat
Clin 6 : 171-176
13. Masquelet AC, Penteado CV (1986) Le lambeau interosseux
postrrieur. Ann Chit Main (sous presse)
14. McCraw JB, Dibbell DG (1977) Experimental definition of
independent myocutaneous vascular territories. Plast Reconstr
Surg 60 : 212-220
15. McCraw JB, Dibbell DG, Carraway JH (1977) Clinical definition
of independant myocutaneous vascular territories. Plast Reconstr
Surg 60 : 341-352
16. McCraw JB, Vasconez LO (1980) Musculo-cutaneous flaps.
Principles. Clin Plast Surg 7 : 9 - 1 3
17. Morin A, Carrault E, Autissier JM, Neidhardt JH (1969)
Remarques sur l'anatomie des art~res interosseuses de l'avant-
bras. CR Assoc Anat 54 : 301-311
18. Mfihlbauer W, Herudl E, Stock W (1982) The forearm flap. Plast
Reconstr Surg 70 : 336-342
19. Pontrn B (1981) The fascio-cutaneous flap: its use in soft tissue
defects of the lower leg. Br J Plast Surg 34 : 215-220
20. Rouvirre H, Detmas A (1984) Anatomie Humaine Descriptive,
Topographique et Fonctionnelle, Tome 3, Masson, Paris
21. Salmon M (1936) Artrres de la peau. Masson, Paris
22. Schoofs M, Bienfait B, Calteux N, Dachy Ch, Van Dermaeren
CA, De Conink A (1983) Le lambeau apondvrotique de
l'avant-bras. Ann Chir Main 3 : 197-201
23. Song R, Gao Y, Song Y, Yu Y, Song Y (1982) The forearm flap.
Clin Plast Sarg 9 : 2 1 - 2 6
24. Soutar DS, Scheker LR, Tanner NBS, McGregor IA (1983) The
radial forearm flap: a versatile method for intra-oral recons-
truction. Br J Plast Surg 36 : 1-8
25. Taylor GI, Daniel RK (1975) The anatomy of several free flaps
donor sites. Plast Reconstr Surg 56 : 243-253
26. Testut L (1890) Trait6 d'Anatomie Humaine, Tome 2, Doin, Paris
27. Valdecasas-Huelin JMG, Barreiro FJJ, Barcia EC (1978) Etude
radio-anatomique des artrres interosseuses. Acta Anat 102:
147-156
28. Yang Guofeng, Chen Baoqui, Gao Yuzhi (1981) Forearm free
skin flap transplantation. Natl Med J China 61 : 139 (Abstracted
in Plast Reconstr Surg 1982, 69 : 1041)