Osteoplasty Surgery for Hand Mutilation

A mutilating hand injury might 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 definitive reconstruction.

Nineteen patients sustained mutilating hand injuries with thumb amputations proximal to the metacarpophalangeal joint level or wrist amputation at the basal joint level. They underwent osteoplastic surgery for composite reconstruction under emergency or acute conditions.

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

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