Composite osteoarthrotenocutaneous free flap from the foot for reconstruction of an unusual hand wound.

A case of a single-stage reconstruction of the left hand of a 32-year-old right-handed construction worker with a shotgun wound by means of a composite osteoarthrotenocutaneous free flap from the foot is presented. The tissue loss caused by the injury included the cutaneous coverage of the dorsum of the left hand, extensor tendons of the second, third, fourth and fifth digits, metacarpals of the same fingers, and the second and third metacarpophalangeal joints. After 8 years of evolution, we have been able to verify a valuable degree of functional capability of the reconstructed hand.