Mishra J K, Sahu S A, Sindhuja A, Kar B K, Saha A
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Raipur, India.
Department of Orthopaedics, All India Institute of Medical Sciences, Raipur, India.
Malays Orthop J. 2024 Nov;18(3):71-74. doi: 10.5704/MOJ.2411.010.
Free fibula flap has been a workhorse for head, neck, and extremity long bone defects. We discuss the reconstruction challenge in an unusual hand injury case involving the loss of multiple metacarpals and soft tissue with surprising preservation of finger vascularity. The reconstructive goals were addressed with a microvascular osteocutaneous fibula flap transfer with multiple osteotomies to create spitting images of metacarpals and soft tissue defects restored with the skin paddle. The outcome, in terms of functional gain, was sufficient for managing day-to-day activities. We share our experience in reconstructing this unique presentation of a complex hand injury.
游离腓骨瓣一直是修复头颈部和四肢长骨缺损的常用方法。我们讨论了一例不寻常的手部损伤病例中的重建挑战，该病例涉及多根掌骨缺失和软组织缺损，而手指血管却意外得以保留。通过微血管骨皮瓣腓骨转移术并进行多处截骨，以形成掌骨的镜像并利用皮瓣修复软组织缺损，从而实现了重建目标。在功能恢复方面，结果足以满足日常活动的需求。我们分享了在重建这种独特的复杂手部损伤病例中的经验。
