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Hand reconstruction methods using posterior interosseous flaps have the merits of being thin and pliable, they do not require sacrifice of any major hand arteries, and closure of the donor site is readily performed. Drawbacks include unreliability of blood flow due to the presence of posterior interosseous artery anatomic variants or damage to the venous circulation. We present some modifications to methods for the preparation of posterior interosseous flaps with which we have achieved some favorable results.

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