The combined reconstruction of fingers
The article presents a novel approach to gradual finger reconstruction, with soft tissue being restored at the first stage by way of a non-free lipocutaneous flap coverage, and the finger osteal structure being formed during the second phase by transfer of a vascularized bone graft or the second toe with a corresponding metatarsal fragment. Separation of the soft tissue and bone structure reconstruction stages provides for prevention of ischemic complications and achievement of adequate functional and cosmetic results in most severe hand deformity cases. Indications to various types of flap coverage techniques are defined depending on the type of the bone transplant and nature of hand deformity. Complete acceptance of osteocutaneous transplants was registered in 92.8% of cases, handgrip was recovered or improved in all the patients.