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Among these options reverse Posterior Interosseous Artery flap (PIA) is a much favoured technique.
Objective: To assess the efficacy of reverse flow posterior interosseous artery flap for the coverage of large variety of hand/wrist defects.
Between the developing radius and ulna a branch arises from the axis artery and passes dorsally as the posterior interosseous artery.
It is supplied by the posterior interosseous artery, which is a branch of the common interosseous artery or by the ulnar artery directly.

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