A Case Report of a Free Vascularized Fibular Graft for Hand Reconstruction: Defect at the Metacarpal Region

Abstract

(objective) A case report of a free vascularized fibular graft (FVFG) for hand reconstruction for a defect at the metacarpal region.
(case) A 21-year-old male was injured in a traffic accident and brought to another hospital by ambulance.
The diagnoses were open multiple fractures of carpal bones and phalanges.
Five days after injury, he was referred to our hospital. He was unable to move his fingers or wrist joints. We immediately performed Ilizarov external fixation. After the first operation, he became able to move his fingers actively and the wrist joint passively.
Two weeks after the first operation, we performed FVFG bridging from the lunate bone to the 4th and the 5th metacarpal heads, and tendon transfers from the 4th and 5th EDC to the 3rd EDC.
(result) Nine months after FVFG, bone fusion was complete. The range of motion of the little finger and wrist joint remained limited, but he returned to work.
(discussion) As the fibular bone used was strong, rehabilitation began earlier than if another method had been used. The final result was good.