Immediate Autologous Fillet Bone Grafting for Thumb Metacarpal Defect in a Severe Mangled Hand

Abstract

Severe mutilating open injuries of hand with bone loss are challenging clinical problems for hand surgeons. Though there are many reconstructive options for these injuries, immediate and one stage bony defect restoration with anatomical reduction seem to be an ideal method. It can be accomplished with the help of autologous bone graft from other amputated part of hand. We report a case of severe open hand injury with first metacarpal bone loss. To preserve thumb as well as hand function, autologous bone graft for metacarpal and basal joint reconstruction of thumb was harvested from proximal phalanx of ipsilateral index finger which was destined for amputation due to unsalvageable of the second ray. The interposed bone graft incorporated well into first metacarpal bone and basal joint function was restored in one year follow-up. Functional results were achieved satisfactorily.