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Treatment of Metacarpophalangeal Joint Traumatic Defects Using a Pedicle Osteoarticular Flap from the 3rd Carpometacarpal Joint in 27 Cases With Follow-up Over 2 Years
Xu Zhang, MD
Hand Surgery Department, The Second Hospital of Qinhuangdao, Changli, Qinhuangdao

To introduce the use of a pedicle osteoarticular flap taken from the 3rd carpometacarpal joint for the treatment of metacarpophalangeal (MCP) joint traumatic defects. From February 2006 to May 2011, 27 patients with traumatic defects on the MCP joints were treated in the Second Hospital of Qinhuangdao. The mean age of the patients at reconstructive surgery was 33 years. The osteoarticular defects were located in the thumb (n=11), index finger (n=8), long finger (n=6), and ring finger (n=2). Of the 27 patients, 21 presented with acute injuries and 6 presented with old injuries. At the mean final follow-up of 26 months, the mean motion arc of the reconstructed MCP joints and the opposite joints was 44° and 93°, respectively, and the mean pinch strength of the injured and opposite sides was 5.1 kg and 7.5 kg, respectively. For the 6 patients with old injuries to their digits, the mean pre- and postoperative range of motion was 4° and 40°, and the mean pre- and postoperative pinch strength was 1.4 kg and 5.6 kg, respectively. The mean Disabilities of the Shoulder, Arm, and Hand score of the entire patient series was 8; the mean pre- and postoperative scores of the 6 patients with old injuries were 43 and 15, respectively. The use of a pedicle osteoarticular flap harvested from the 3rd carpometacarpal joint is a reliable technique for the treatment of traumatic defects on the MCP joints.


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