Vascularization of the Dorsal Base of the Second Metacarpal Bone

Fingertip trauma with resultant bony loss is optimally reconstructed with an autologous bone substitute, offering a unique opportunity for use of a local vascularized bone graft. The second dorsal metacarpal artery is well-described for use in soft tissue and bony reconstruction, with recent cadaveric studies suggesting a reverse-flow second dorsal metacarpal artery bone flap could reach defects in the distal phalanx. The aim of the current report is to illustrate the use of this technique in reconstructing the distal digit in a traumatized index finger with bony loss of the middle third of the distal phalanx. A 49-year-old man presented with a traumatic circular saw injury to his left index finger, with the unique finding of distal phalanx bony loss to the middle third of this bone, with no associated disruption of palmar or dorsal structures. Reconstructive goals were solely that of bony reconstruction, with no soft tissue coverage required. A reverse SDMA vascularized bone flap was successfully used for reconstruction, with the vascularized bone flap mobilized on its reverse SDMA pedicle and pivoted at the level of the distal anastomoses between the palmar and dorsal metacarpal arteries. There was uncomplicated donor and recipient site closures, and good functional outcomes with the ability to retain full distal interphalangeal joint motion and force on distal pinch grip. This case shows that the reverse second dorsal metacarpal artery vascularized bone flap may be undertaken to reconstruct bony loss in the distal phalanx.

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Reverse second dorsal metacarpal artery vascularized bone flap for index distal bone loss: A case report

Katz

Hunter-Smith

Rozen

2015

Microsurgery

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Anatomical study of all carpal and adjoining bones of the wrist using 3D CT reconstruction –Finding the ultimate biomechanical theory

Gill

Lyer

Fried

et al. 2022

Annals of Anatomy - Anatomischer Anzeiger

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Vascularized Bone Flaps for the Treatment of Kienböck Disease

Florczynski¹,

Chung²

2022

Hand Clinics

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Vascularization of the Dorsal Base of the Second Metacarpal Bone

Abstract: Pedicled vascularized bone grafts from this area are suitable for clinical application to treat Kienböck disease if standard donor sites are unavailable.

Cited by 9 publications

References 38 publications

Reverse second dorsal metacarpal artery vascularized bone flap for index distal bone loss: A case report

Reverse second dorsal metacarpal artery vascularized bone flap for index distal bone loss: A case report

Anatomical study of all carpal and adjoining bones of the wrist using 3D CT reconstruction –Finding the ultimate biomechanical theory

Vascularized Bone Flaps for the Treatment of Kienböck Disease

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