title: Late reconstruction of neglected metacarpal shaft defects due to gunshot wound.
abstract: We evaluated eight patients after delayed treatment of nine metacarpal bone defects due to gunshot injuries. The mean length of the metacarpal defects was 3 cm and the average time between the gunshot injury and the reconstruction surgery was 10 months. Although all of the patients had been treated with wound irrigation and debridement immediately following injury, no attempt had been made to repair the metacarpal defect or to maintain metacarpal length. As a result, serious shortening had occurred. After the original length of the metacarpal had been restored by distraction of the soft tissues (1 mm/day), a tri-cortical iliac bone graft was inserted into the bone defect. The average follow-up time was 15 months. Clinical and radiological union was established in all cases after an average of 12 weeks. The mean grip strength of the hand and the mean range of motion of the metacarpophalangeal joint increased by 24% and 60%, respectively.
authors.affiliation: Department of Orthopedics and Traumatology, Gulhane Military Medical Academy and Medical Faculty Hospital, Istanbul, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akmaz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kiral
authors.forename: Ozcan
authors.initials: O
authors.lastname: Pehlivan
authors.forename: Mahir
authors.initials: M
authors.lastname: Mahirogullari
authors.forename: Can
authors.initials: C
authors.lastname: Solakoglu
authors.forename: Osman
authors.initials: O
authors.lastname: Rodop
authors.forename: Mesih
authors.initials: M
authors.lastname: Kuşkucu
mesh_terms: D000328:Adult; D016025:Bone Transplantation; D005384:Finger Joint / Q000503:physiopathology; D050723:Fractures, Bone / Q000209:etiology / Q000601:surgery*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008663:Metacarpus / Q000293:injuries* / Q000601:surgery*; D008889:Military Personnel; D019857:Osteogenesis, Distraction; D016059:Range of Motion, Articular / Q000502:physiology; D013997:Time Factors; D014421:Turkey; D014948:Wounds, Gunshot / Q000503:physiopathology / Q000601:surgery*