Triangular Vascularized Free Fibula Flap for Massive Carpal Reconstruction

David Graham; Brahman Sivakumar; Francisco Del Piñal

doi:10.1016/j.jhsa.2021.05.015

Triangular Vascularized Free Fibula Flap for Massive Carpal Reconstruction

J Hand Surg Am. 2022 Feb;47(2):196.e1-196.e6. doi: 10.1016/j.jhsa.2021.05.015. Epub 2021 Jul 1.

Authors

David Graham¹, Brahman Sivakumar², Francisco Del Piñal³

Affiliations

¹ Department of Orthopaedic Surgery, Gold Coast University Hospital, Southport, Australia; Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Australia; Griffith University School of Medicine, Southport, Australia. Electronic address: davegraham80@gmail.com.
² Department of Orthopaedic Surgery, Gold Coast University Hospital, Southport, Australia; Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Australia.
³ Private practice, Madrid and Santander, Spain.

PMID: 34217554
DOI: 10.1016/j.jhsa.2021.05.015

Abstract

Massive carpal loss following trauma, tumor, or infection poses a difficult reconstructive challenge. There are limited reconstructive options for such cases, particularly when the metacarpal bases are also lost. We describe a method of carpal reconstruction using closing wedge osteotomies in a triangular vascularized free fibular flap, and a proposed algorithm for the management of metacarpal instability in this setting.

Keywords: Carpal reconstruction; free fibular; triangular.

Publication types

Review

MeSH terms

Bone Transplantation / methods
Carpal Bones*
Fibula
Free Tissue Flaps*
Humans
Plastic Surgery Procedures* / methods
Retrospective Studies