A 25-year-old male sustained an injury to his hand, resulting in amputation from the base of the little finger, as well as skin loss at the dorsoulnar aspect of the hand. Radiographs showed a defect of the proximal phalanx in the little finger. The patient and his family were eager for replantation even if the finger had to be shortened. The replantation of the little finger was performed by temporarily implanting the middle phalanx on the neck of the metacarpus. Secondary reconstruction was then performed, with the base of the finger fused with an iliac bone graft and the skin loss covered with a reversed posterior interosseous flap. As a result, the right finger, which was fused, was shorter than the left one by 3cm; however, the patient was satisfied with the results and returned to his work as a carpenter. Replantation with a defect of the proximal phalanx may not be the best choice to save hand function, but we believe that it can play a role as it affords the option of secondary reconstruction.
