Vascularized bone blocks from the toe phalanx to solve complex intercalated defects in the fingers

Area of Science:

• Orthopedic surgery
• Microsurgery
• Regenerative medicine

Background:

• Vascularized bone grafts offer superior infection resistance and healing.
• Reconstructing small, vascularized bone segments, like those in finger defects, presents a surgical challenge.

Purpose of the Study:

• To evaluate the efficacy of single-stage reconstruction for traumatic finger bone defects using vascularized toe phalanges.

Main Methods:

• Eight patients with traumatic intercalated compound finger bone defects received vascularized toe phalanx grafts.
• Grafts were pedicled on digital or metatarsal arteries, averaging 12 mm in length with associated skin islands.
• Toe defects were managed with arthroplasty or arthrodesis, preserving the toe.

Main Results:

• Radiologic bone union occurred within 4–6 weeks in most patients.
• Average finger length loss was minimal (3 mm).
• All patients successfully returned to their preoperative occupations.

Conclusions:

• Vascularized toe phalanges provide a reliable solution for single-stage reconstruction of compound finger bone defects.
• This technique demonstrates successful vascularization and minimal donor site morbidity.