Outcome of “Vascularized Bone Graft Spare Parts” Reconstruction of Segmental Metacarpal Deficits of Hand
Journal Title: Journal of Pakistan Orthopaedic Association - Year 2019, Vol 31, Issue 03
Abstract
Objective: To determine the radiological and functional outcome of “vascularized bone graft spare parts” fashioned from severely damaged but viable parts of the hand and used for reconstruction of hand defects. Methods: This descriptive study was conducted from 3rd January 2014 to 25th January 2018 in Millat Orthopaedic and Trauma Surgery Hospital Sargodha. All patients with traumatic hand defects fulfilling the inclusion criteria were reconstructed with vascularized bone graft spare parts technique. Patients were followed regularly for viability of graft, bone union and functions of the hand. Results: A total of 6 patients with mean age 33.3 years (range 19 to 45 years) were included in our study. The aetiology of hand trauma was saw cut in 2(33.3%), crush injury in 2(33.3%), firearm in 1(16.6%) and sepsis in 1(16.6%) patient. Segmental defects in the first metacarpal were present in 3(50%) patients, first and third metacarpal in 2(33.3%) and third metacarpal in 1(16.6%) patient. Vascularized bone graft spare part pedicle of index phalangeal osteocutaneous was used in 6 patients, 2nd metacarpal osseous in 1(16.6%) and ring phalangeal osteocutaneous in 1 (16.6%). The average length of harvested bone graft used was 4.13cm (Range 3 to 5.5cm). All the flaps survived and bones united. Acceptable hand functions were restored in 4(66.6%) and mangled hand in 2(33.3%) patients. All patients resumed their work status and functional results were satisfactory. Conclusion: Severely damaged and complex hand injuries treated with vascularized bone graft spare parts technique had good radiological and functional outcome. We, therefore recommend that vascularized bone graft pedicle spare parts of a severely injured hand should be innovated as a possible source for one stage reconstruction of the hand.
Authors and Affiliations
Muhammad Amin Cheema, Haider Amin Cheema, Hamza Bashir
Keywords
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