title: Osteoarticular pedicle flap from the capitate to reconstruct traumatic defects in the head of the proximal phalanx.
abstract: OBJECTIVE
  To describe the reconstruction of traumatic defects in the head of the proximal phalanx using an osteoarticular pedicle flap from the capitate.
  
  
  METHODS
  From January 2004 to December 2007, we treated 15 patients with traumatic defects of the head of the proximal phalanx at our institution. All of these injuries involved 1 condyle of the proximal phalanx. There were 11 male and 4 female patients; the mean age was 32 years. The injuries occurred in the index (n = 6), middle (n = 7), and ring (n = 2) fingers. At the final follow-up, we assessed space narrowing of the proximal interphalangeal joint and flap necrosis using plain radiography. We measured active motion and pinch and grip strength of the hand and compared all measurements with those on the opposite side. Patients rated injured-joint pain and donor-joint pain using a visual analog scale. We assessed hand function using the Disabilities of the Arm, Shoulder, and Hand scale.
  
  
  RESULTS
  Patient follow-up averaged 52 months. At the final follow-up, we noted narrowing of the proximal interphalangeal joint in 3 cases, but we observed no flap necrosis. The mean active motion arc of the injured and opposite proximal interphalangeal joints was 50° and 96°, respectively. The mean pinch strength of the injured and opposite hands was 5.8 and 6.5 kg, respectively. The mean grip strength of the injured and opposite hands was 39 and 40 kg, respectively. We noted mild recipient joint pain in 6 patients and mild donor joint pain in 1 patient. The mean score of the Disabilities of the Arm, Shoulder, and Hand questionnaire was 9.
  
  
  CONCLUSIONS
  We used an osteoarticular pedicle flap from the capitate to resurface traumatic defects of the head of the proximal phalanx. This approach is acceptable for restoring the contour of the phalangeal head.
authors: Hand Surgery Department, Second Hospital of Qinhuangdao, Changli, Qinhuangdao, Hebei, China. ahand@sina.com
authors: Xu
authors: X
authors: Zhang
authors: Xiugui
authors: X
authors: Fang
authors: Xinzhong
authors: X
authors: Shao
authors: Sumin
authors: S
authors: Wen
authors: Hongwei
authors: H
authors: Zhu
authors: Chunzhen
authors: C
authors: Ren
mesh_terms: D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods*; D051224:Capitate Bone / Q000098:blood supply; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D052581:Pinch Strength / Q000502:physiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D013524:Surgical Flaps / Q000098:blood supply; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult