Vascularized Pedicled Proximal Phalanx Flap for Spare Part for Reconstruction of Metacarpal Avulsion Injury

Summary: Traumatic injuries to the hand with significant loss of bone or soft tissue can be quite difficult to reconstruct and often require an innovative and flexible surgical plan for reconstruction. We present a case of a young manual laborer with a significant crush avulsion injury involving his third and fourth metacarpals. We were able to preserve his fourth metacarpophalangeal joint by utilizing a pedicled vascularized proximal phalanx flap from the nonsalvageable third digit to reconstruct and provide osseous stability to the fourth metacarpal. The patient had excellent functional and aesthetic outcomes with full return to work at his farm by less than 12 months postoperatively.