Archives of Orthopaedic and Trauma Surgery

, Volume 137, Issue 5, pp 719–723 | Cite as

Finger reconstruction using induced membrane technique and ulnar pedicled forearm flap: a case report

  • Olivier Herisson
  • Alain-Charles Masquelet
  • Levon Doursounian
  • Alain Sautet
  • Adeline Cambon-Binder
Handsurgery
  • 227 Downloads

Abstract

Introduction

Injuries referred to as “rollover hands” are associated with multiple and complex lesions of the dorsal aspect of the hand. We present a case of a multitissular reconstruction following a severe injury of the dorsum of the fingers in a 45-year-old woman.

Materials and methods

The bone loss reconstruction was performed in two stages using the Masquelet induced membrane technique. In the first stage, a cement spacer was inserted into the phalanx bone defects. For the second stage, the membrane induced by the foreign-body reaction was opened, the spacer was removed, and an autologous cancellous bone graft was inserted into the defects. The skin coverage was obtained using a reverse ulnar artery forearm pedicled flap. The digits were covered jointly. Three surgical procedures over the course of a 2-month period were required to desyndactylize the fingers and to defat the flap.

Results

At the 2-year follow-up examination, the patient exhibited good integration of their hand use in daily living. The esthetic result was deemed to be satisfactory. Definitive bone consolidation occurred 4 months after the second stage.

Conclusions

Rollover hands are typically a challenge for both the patient and the hand surgeon. The risk of septic complications, as well as the need for several stages of surgical reconstruction, makes the Masquelet technique particularly attractive for the treatment of phalanx bone defects consecutive to rollover injuries.

Keywords

Rollover hand Masquelet technique Induced membrane technique Ulnar artery forearm flap Bone reconstruction 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

There is no funding source.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the participant included in the study.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Orthopaedic, Trauma, and Hand SurgerySaint Antoine HospitalParisFrance
  2. 2.Université Pierre et Marie Curie Paris 6ParisFrance

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