A 28-year-old man was referred to our hospital because of localised swelling of his fingers, with suspicion of arthritis of the proximal interphalangeal (PIP) joints. At physical examination we observed a swelling, superficial to the PIP joints. Ultrasonography revealed a hypo-echoic structure above the extensor tendon, typical for knuckle pads.
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Finger reconstruction with vascularized partial osteo-onycho-cutaneous great toe transfer: It's time to address the donor site.
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Free vascularized partial great toe is a composite tissue consisting of the osteo-onycho-cutaneous component with neurovascular pedicle and is used for reconstructing amputated fingers at different levels. The half-big-toe nail flap represents that while it provides a good match and functional results; it also conserves the donor foot by having all five toes intact. The aesthetic and functional aspects of the amputated thumbs and fingers can be worked upon and significantly improved.
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Indian J Plast Surg
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While proximal phalangeal joint injuries with comminution of the base of the middle phalanx are common injuries, proximal interphalangeal (PIP) joint fracture dislocations with an intact base of middle phalanx and a comminuted head of proximal phalanx are rare. Volar plate arthroplasty and other described techniques prevail for the former injury, while the latter does not have any supportive literature on the exact method of management. We herein present a 20-year-old male with a severely comminuted head of proximal phalanx fracture with dislocation of the PIP joint, which was not reconstructable but was managed successfully with a novel technique of volar plate draping that resurfaced the raw phalangeal head.
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