ePlasty: Vol. 10
Immediate Reconstruction of Complex Hand Trauma With Iliac Crest Bone Graft and 2 Pedicled Fasciocutaneous Skin Flaps: A Case Report
Stéphane Stahl, MD,a Oliver Lotter, MD,a Adelana Santos Stahl, MD,b Hans-Eberhard Schaller, MD,a and Nektarios Sinis, MDa

aDepartment of Plastic, Hand and Reconstructive Surgery, Burn Center, BG-Trauma Center, Eberhard-Karl University of Tübingen, Germany; bDepartment of Plastic and Reconstructive Surgery, Marienhospital, Stuttgart, Germany

Correspondence: sstahl@bgu-tuebingen.de

Objective: The decision about primary or staged reconstruction of all structures in severe hand injuries is controversial. The purpose of this case report is to present a surgical protocol that lead to good functional results and rapid recovery after primary bone grafting with pedicled flap coverage of a complex hand injury. Methods: A case is reported in which 2 iliac crest bone grafts, an extended dorsal metacarpal artery flap and a heterodigital island flap, were performed at primary intervention to reconstruct the index and middle fingers of a 17-year-old patient. Results: Length and sensation of the digits were fully preserved while the destroyed joints were fused and covered with mobile soft tissue. Hereby, a satisfactory pinch grip and hand closure was restored, allowing the patient to return to work after only 2 months. Concl .......