Reconstruction of a metacarpal head defect due to bite injury: two case reports

Nakanishi, Akito; Kawamura, Kenji; Omokawa, Shohei; Shimizu, Takamasa; Tanaka, Yasuhito

doi:10.1080/23320885.2018.1509717

Cited by 3 publications

(8 citation statements)

References 22 publications

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“…Small defects of the finger joints may be repaired with osteochondral plugs from the distal femur 19,20 or costal cartilage 19,21 . However, complete reconstruction of the metacarpal head and the use of an external fixator may be more advantageous, as evidenced by the increased range of motion and the lower DASH score than those reported by Nakanishi et al 18 …”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the Fourth Metacarpal Using a Chimeric Medial Femoral Condyle Vascularized Osteochondral Cutaneous Graft

Jorge

Estler²,

Wahler³

et al. 2022

Ann Plast Surg

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Background: The medial femoral condyle has become a matter of great interest, thanks to the possibility of harvesting versatile chimeric flaps for reconstruction of metacarpal defects with minimal donor site morbidity. This case stands out because of the complete reconstruction of the metacarpal head, harvesting with a skin paddle for tension-free closure and monitoring, and the use of external fixation for better predictability of the reconstruction and early postoperative mobilization. Case Presentation: We report the case of a 20-year-old male patient who presented with an aneurysmal bone cyst involving the fourth metacarpal bone. The patient underwent resection en bloc of the metaphysis and distal epiphysis of the fourth metacarpal bone, and the bone defect was reconstructed using a 3.4-cm vascularized osteochondral cutaneous graft from the medial femoral condyle. Results: At 1-year follow-up, the patient showed no impairment in hand range of motion and had a Disabilities of Arm, Shoulder and Hand score inferior to that of the male healthy population. Almost 5 years after the procedure, the radiographic examination did not reveal signs of arthrosis. This case report shows that the medial femoral condyle is an excellent and versatile source of vascularized osteochondral grafts for reconstruction of metacarpal defects.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of the Fourth Metacarpal Using a Chimeric Medial Femoral Condyle Vascularized Osteochondral Cutaneous Graft

Jorge

Estler²,

Wahler³

et al. 2022

Ann Plast Surg

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“…Apart from the aforementioned complications, the researchers also observed that out of the 13 joints, two exhibited lucency in the area of the phalangeal component, while one exhibited some degradation in the metacarpal component [99]. Subluxation of the unconstrained component was also reported by other researchers [100][101][102][103]. Like is the case with PIP joint surface replacement arthroplasty, MCP joint surface replacement arthroplasty has varying success rates since some patients are reported to experience dislocations of unconstrained implants.…”

Section: Mcp Joint Surface Replacementmentioning

confidence: 74%

Silicone and Pyrocarbon Artificial Finger Joints

Alnaimat

Owida

Sharah

et al. 2021

Applied Bionics and Biomechanics

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Artificial finger joint design has been developed through different stages through the past. PIP (proximal interphalangeal) and MCP (metacarpophalangeal) artificial finger joints have come to replace the amputation and arthrodesis options; although, these artificial joints are still facing challenges related to reactive tissues, reduced range of motion, and flexion and extension deficits. Swanson silicone artificial finger joints are still common due to the physician’s preferability of silicone with the dorsal approach during operation. Nevertheless, other artificial finger joints such as the pyrocarbon implant arthroplasty have also drawn the interests of practitioners. Artificial finger joint has been classified under three major categories which are constrained, unconstrained, and linked design. There are also challenges such as concerns of infections and articular cartilage necrosis associated with attempted retention of vascularity. In addition, one of the main challenges facing the silicone artificial finger joints is the fracture occurring at the distal stem with the hinge. The aim of this paper is to review the different artificial finger joints in one paper as there are few old review papers about them. Further studies need to be done to develop the design and materials of the pyrocarbon and silicone implants to increase the range of motion associated with them and the fatigue life of the silicone implants.

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“…Besondere Beachtung, auch im Hinblick auf Osteomyelitiden, sollten Menschen-und Tierbisse im Bereich der Hand bekommen. Speziell Katzenbissverletzungen, aufgrund der lanzettenartigen Zahnform mit möglicher schneller Eindringtiefe bis zum Knochen, und Hundebissverletzungen, aufgrund des oft erheblichen Riss-Quetsch-Gewebetraumas durch die starke Kraftentwicklung des Kiefers, stellen bei großer Verbreitung dieser Tiere ein besonderes Risiko dafür dar und werden häufig als Traumaursache beschrieben [2,[16][17][18][19]. Aber auch exotische Tiere finden zunehmende Verbreitung in der Tierhaltung und müssen in diese Überlegungen einbezogen werden [20].…”

Section: Posttraumatische Osteomyelitisunclassified

“…Diese ersten chirurgischen Maßnahmen der Infektsanierung müssen kompromisslos erfolgen und avital-entzündliches Gewebe gründlich entfernen, ohne die Keime zu verschleppen. Dabei [2,8,12,19,22,24,27,29].…”

Section: Operative Therapieunclassified

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Osteitis/Osteomyelitis an Hand und Handgelenk

Lautenbach

Tenbrock

Böck

et al. 2021

Handchir Mikrochir Plast Chir

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ZusammenfassungDie Osteomyelitiden im Bereich von Handgelenk und Hand sind weniger häufig als die Knocheninfektionen der langen Röhrenknochen, aber nicht selten. Viele Fragen zur Klassifikation, Pathogenese, Diagnostik, zum Therapiemanagement sowie den erreichbaren Behandlungsergebnissen sind bisher nur wenig ausreichend wissenschaftlich kontrolliert. Die Pathogenese der Erkrankung kann in posttraumatische, postoperative, fortgeleitete und hämatogene Osteomyelitiden, unter Erfassung der patientenindividuellen Risiken, eingeteilt werden. Eine frühe Diagnose und eine adäquate Therapie sind notwendig, um die betroffenen knöchernen Strukturen sowie die Funktion der angrenzenden Gelenke zu erhalten. Ein mehrzeitiges operatives Vorgehen ist dabei häufig notwendig. Zufriedenstellende Raten der Infektionskontrolle und erfolgreiche knöcherne Rekonstruktionen können meist erreicht werden. Komplikationen, verbleibende Defizite und partielle Amputationen, auch bei angemessener Therapie der Osteomyelitiden, sind auf Grund der Schwere der Erkrankung aber nicht immer zu verhindern.

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Reconstruction of a metacarpal head defect due to bite injury: two case reports

Cited by 3 publications

References 22 publications

Reconstruction of the Fourth Metacarpal Using a Chimeric Medial Femoral Condyle Vascularized Osteochondral Cutaneous Graft

Reconstruction of the Fourth Metacarpal Using a Chimeric Medial Femoral Condyle Vascularized Osteochondral Cutaneous Graft

Silicone and Pyrocarbon Artificial Finger Joints

Osteitis/Osteomyelitis an Hand und Handgelenk

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