Osteoplasty Surgery for Hand Mutilation

A mutilating hand injury may present an extensive bone and soft tissue defect that requires a flap for coverage. A pedicled groin flap is frequently used, and an accompanying iliac bone can be elevated as a vascularized bone graft for either temporary or definite reconstruction.

Nineteen patients who sustained hand mutilating injuries with thumb amputations proximal to the metacarpophalangeal joint level or wrist amputation at the basal joint level underwent osteoplastic surgey for composite reconstruction in emergency or acute procedures.

All 19 groin flaps were viable after flap division in 4–5 weeks. Morbidities included a pseudojoint and skin flap ulceration. Ten patients accepted the osteoplasty as permanent surgery. Nine patients underwent toe transfers for secondary functional reconstruction. Finally, 12 patients achieve basic hand reconstruction.

Conventional osteoplasty surgery with a pedicled groin flap with accompanying vascularized iliac bone can provide either a basic hand reconstruction or a preparation for secondary toe transfer to improve the function of a mutilating hand injury.