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Reconstruction of Radio-Lunate Articulation With Grafts From Second Metatarsophalangeal Joint Using 3D Planning: A
Amr Eisa1,2, Mirjam Thielen1,2, Leila Harhaus3
1Department of Plastic, Hand and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwigshafen am Rhein.
Case:
A 12-year-old girl with post-traumatic destruction of the radiolunate joint underwent CT-based three-dimensional (3D) planning with patient-specific guides/plate and a free, nonvascularized transfer of the second metatarsophalangeal joint: the proximal phalanx base resurfaced the lunate fossa and the second metatarsal head reconstructed the lunate using Osteochondral Autologous Transfer System. At 1 year, wrist pain resolved, near normal range of motion was achieved with a DASH score of 5. CT showed complete graft integration. Gait analysis showed no clinically relevant donor-site deficit.
Conclusion:
3D-planned, osteochondral reconstruction of radiolunate articulation using grafts from the second metatarsophalangeal joint can preserve motion with minimal donor morbidity in skeletally immature patients.
Level Of Evidence:
Case report, Level V.

