Custom-made non-vascularized toe-to-finger graft for proximal phalanx condyle reconstruction

Area of Science:

• Orthopedic surgery
• Hand surgery
• Reconstructive surgery

Background:

• Proximal phalanx condylar lesions are common, but total condylar defects present significant therapeutic challenges.
• Complex hand trauma requires innovative reconstructive solutions.

Observation:

• A 19-year-old male experienced extensive hand trauma from a circular saw, resulting in a complete lateral condyle defect of the middle finger's proximal phalanx.
• The injury also involved damage to the lateral ligaments and extensor system.

Findings:

• A custom-made, non-vascularized composite graft from the second toe was utilized for reconstruction.
• The graft successfully restored the condyle, lateral ligaments, and a portion of the extensor system.

Implications:

• This case demonstrates the viability of non-vascularized toe grafts for complex proximal phalanx condylar defects.
• Successful reconstruction enabled a patient to return to manual labor (carpentry) within 6 months post-surgery.