Reconstruction of Metacarpals of Two Rays with Double Barrel Osteocutaneous Fibular Flap in a Hand Injury with Composite Tissue Loss: A Case Report

J K Mishra; S A Sahu; A Sindhuja; B K Kar; A Saha

doi:10.5704/MOJ.2411.010

Reconstruction of Metacarpals of Two Rays with Double Barrel Osteocutaneous Fibular Flap in a Hand Injury with Composite Tissue Loss: A Case Report

Malays Orthop J. 2024 Nov;18(3):71-74. doi: 10.5704/MOJ.2411.010.

Authors

J K Mishra¹, S A Sahu¹, A Sindhuja¹, B K Kar², A Saha¹

Affiliations

¹ Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Raipur, India.
² Department of Orthopaedics, All India Institute of Medical Sciences, Raipur, India.

Abstract

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.

Keywords: free fibula flap; metacarpal loss; metacarpal reconstruction.

Publication types

Case Reports