Treatment for Interphalangeal Joint Infection with Osteomyelitis Using the Masquelet Technique and Dorsoulnar Flap

Abstract

　As the dorsal skin of the interphalangeal joint is thin, interphalangeal joint infection after minimal injury is common. Debridement is required to treat the infection, but it may cause deformity and loss of strength. Thumb complications are frequent; therefore, the function should be preserved as much as possible. In this report, we treated interphalangeal joint infection with osteomyelitis using the Masquelet technique and dorsoulnar flap, and obtained a good result. The patient was a 63-year-old man with diabetes. Pus was observed from the dorsal skin of his left thumb. We performed debridement and inserted a spacer. After two months, we confirmed control of the infection and performed bone grafting. At the time, there was loss of the dorsal skin of the interphalangeal joint, which was covered by a dorsoulnar flap. The flap was not congested and bone union in the thumb was acquired after 6 months. The DASH score was 0 points and the Hand20 score was 2.5 points. Treatment of interphalangeal joint infection with osteomyelitis using the Masquelet technique and dorsoulnar flap was effective.