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Ulnar Head Reconstruction with Microvascular Second Metatarsal.

Pedro C Cavadas1, Alessandro Thione1

  • 1Reconstructive Surgery, Clinica Cavadas, Hospital de Manises, Valencia, Spain.

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|May 17, 2017
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Summary

Autologous reconstruction of the ulnar head using microvascular second metatarsal grafts shows promise for forearm instability. This technique may be a viable alternative to prostheses in trauma, oncological, and congenital cases.

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Area of Science:

  • Orthopedic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • The distal radioulnar joint, proximal radioulnar joint, and interosseous ligament form a system crucial for forearm pronation-supination.
  • The ulnar head plays a key role in forearm rotation and load transmission at the distal radioulnar joint.
  • Autologous reconstruction of the ulnar head is theoretically advantageous over prosthetic options.

Purpose of the Study:

  • To report on the feasibility and outcomes of autologous ulnar head reconstruction using microvascular second metatarsal grafts.
  • To evaluate this technique in diverse etiologies including trauma, oncological resection, and congenital deformities.

Main Methods:

  • Three patients underwent ulnar head reconstruction.
  • Microvascular free tissue transfer utilizing the second metatarsal was performed for reconstruction.
  • Cases represented trauma, oncological, and congenital conditions.

Main Results:

  • All three cases achieved good clinical outcomes.
  • No instances of instability were reported post-operatively.
  • The technique demonstrated successful restoration of ulnar head function.

Conclusions:

  • Autologous reconstruction with microvascular second metatarsal grafts appears to be a feasible treatment for ulnar head defects.
  • This reconstructive approach shows potential applicability in post-oncological resections and congenital cases.
  • The technique offers a viable alternative for managing complex distal radioulnar joint issues.