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Triangular Vascularized Free Fibula Flap for Massive Carpal Reconstruction
David Graham1, Brahman Sivakumar2, Francisco Del Piñal3
1Department of Orthopaedic Surgery, Gold Coast University Hospital, Southport, Australia; Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Australia; Griffith University School of Medicine, Southport, Australia.
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.
