title: The use of a third metacarpal base osteoarticular flap for treatment of metacarpophalangeal joint traumatic defects.
abstract: OBJECTIVE
  To describe the use of a pedicled osteoarticular flap harvested from the base of the third metacarpal for the treatment of traumatic defects of the metacarpophalangeal (MCP) joints.
  
  
  METHODS
  From February 2006 to January 2008, we included in the study 15 patients with posttraumatic defects of the MCP joints. The mean age of the patients was 35 years. The injured MCP joints were located in the thumb (n = 6) and index (n = 4), middle (n = 4), and ring fingers (n = 1). Of the 15 patients, 10 presented with acute injuries and 5 with old injuries. At follow-up, we assessed active motion and pinch strength and compared all measurements with those from the opposite hand. In patients with old MCP joint injuries, we also compared preoperative and postoperative motion and pinch strength. We assessed hand function using the Disabilities of the Arm, Shoulder, and Hand questionnaire.
  
  
  RESULTS
  At the final follow-up (mean, 28 mo), the mean motion arc of the reconstructed MCP joints and the opposite joints was 46° and 91°, respectively, and the mean pinch strength of the injured and opposite sides was 5.4 and 7.1 kg, respectively. For the 5 patients with old injuries to the fingers, the mean preoperative and postoperative motion arc was 2° and 43°, and the mean preoperative and postoperative pinch strength was 1.6 and 5.3 kg, respectively. The mean Disabilities of the Arm, Shoulder, and Hand score of the entire patient series was 9, whereas the mean preoperative and postoperative scores of the 5 patients with old injuries were 44 and 17, respectively.
  
  
  CONCLUSIONS
  The use of a pedicled osteoarticular flap harvested from the base of the third metacarpal is a reliable technique for the treatment of traumatic defects of the MCP joints.
authors.affiliation: Hand Surgery Department, Second Hospital of Qinhuangdao, Changli, Qinhuangdao, Hebei, China. ahand@sina.com
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.forename: Xiugui
authors.initials: X
authors.lastname: Fang
authors.forename: Xinzhong
authors.initials: X
authors.lastname: Shao
authors.forename: Sumin
authors.initials: S
authors.lastname: Wen
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhu
authors.forename: Chunzhen
authors.initials: C
authors.lastname: Ren
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000098:blood supply / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008663:Metacarpus; D008866:Microsurgery / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D013524:Surgical Flaps / Q000098:blood supply; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult