“Recycling Technique” for Single-Stage Metacarpal Hand Reconstruction
Abstract
Introduction: We present an innovative surgical technique for reconstructing a metacarpal hand following transmetacarpal amputation. The procedure consists of lengthening the fourth ray using the second metatarsal as a non-vascularized bone graft to create a functional opposition post, complementing a second-toe transfer to the hand. This approach allows reconstruction of a metacarpal hand in a single surgical stage and with a single toe transfer, thereby avoiding complications associated with additional bone-graft donor sites. We also describe the functional and aesthetic outcomes obtained in our sole case to date. No published reports of a similar technique were identified. Conclusions: Harvesting the metatarsal from the donor toe facilitates improved closure of the intermetatarsal space with a lower risk of donor-site complications, while also providing a non-vascularized bone graft that serves as an opposition mass for the transferred toe. This simplifies the surgical procedure and reduces the risk of complications.Downloads
References
Maduri P, Akhondi H. Upper limb amputation. StatPearls 2021 [Internet]. Disponible en:
https://www.ncbi.nlm.nih.gov/books/NBK540962/
Dillingham T, Pezzin L, Mackenzie. Limb amputation and limb deficiency: Epidemiology and recent trends in the
United States. South Med J 2002;95(8):875-83. https://doi.org/10.1097/00007611-200208000-00018
ALDeek NF, Lin YT, Wei FC. Metacarpal-like and metacarpal hand. Hand Clin 2016;32(4):549-54.
https://doi.org/10.1016/j.hcl.2016.06.004
Barca F, Santi A, Tartoni P, Landi A. Gait analysis of the donor foot in microsurgical reconstruction of the thumb.
Foot Ankle Int 1995;16(4):201-6. https://doi.org/10.1177/107110079501600406
del Piñal F. Extreme thumb losses. Plast Reconstr Surg 2019;144(3):665-77. https://doi.org/ 10.1097/PRS.0000000000005983
Lin CH, Lo S, Lin CH, Lin YT. Opponensplasty provides predictable opposable tripod pinch in toe transfer for
proximal thumb ray defect reconstruction. Plast Reconstr Surg 2012;130(6):810e-818e.
https://doi.org/10.1097/PRS.0b013e31826d1628
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