Tuberculous dactylitis is infrequently seen after the age of 6 years. The index and middle fingers are the most common sites. Early diagnosis is essential to eradicate the infection. Delay in diagnosis and management leads to extensive involvement which may require surgical intervention. The current literature reveals conservative management gives satisfactory results in early stages. Though surgical intervention in Tuberculous dactylitis is seldom required, delay in diagnosis and management leads to extensive involvement of the bone and sequestration which does not respond to Anti Tubercular Therapy and needs staged surgical interventions. We report a case of an 11-year-old girl who presented to us after extensive involvement of 2nd and 3rd metacarpals and failed to respond to ATT even after 1.5 years of medication. She required staged surgeries to eradicate the infection which led to loss of 2nd and 3rd metacarpals. Complex reconstructive procedures of hand were required in stages and the bone loss was managed with non-vascularized Fibular strut graft. At 2 years of follow up, there is complete incorporation of the graft, and the patient has satisfactory functions of the hand and can carry out activities of daily living with ease.
Keywords: Dactilytis; Metacarpal Loss; Reconstruction; Tuberculosis.
© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.