Reconstructive Principles for the Metacarpal Hand: Case Report

Abstract

Metacarpal hand is one of the most devastating upper-extremity lesions. We report a case of a multidigit amputation corresponding to a Wei et al.5 IA metacarpal hand in a 56 year-old-male. He underwent a sequential toe-to-hand transfer to the third and fourth radii. Reconstruction of the metacarpal hand, either in an acute or deferred presentation, must consider some reconstructive principles, including the identification of the structures to be spared and the coverage strategies for the acute stage. Toe-to-hand transfer is the preferred technique when replantation is not an option. It is critical to know which structures should be transferred to which positions, as well as to adapt the reconstructive plan to the characteristics from each patient.