title: Synostosis of proximal phalangeal bases for loss of distal metacarpal.
abstract: A finger rendered unstable due to loss of metacarpal head can be stabilized by creating a synostosis at the base of the proximal phalanx of the affected finger with the adjacent normal finger. A cortico cancellous graft bridges the two adjacent proximal phalanges at their bases which are temporarily stabilized with an external fixator. The procedure can be done for, recurrence of giant cell tumor of metacarpal and for traumatic metacarpal loss. The procedure and long term follow up of one patient is presented who had giant cell tumor. This option should be considered before offering ray amputation. There is no micro vascular surgery involved, nor is there any donor site morbidity. The graft heals well without any absorption. The affected finger shows excellent function in the long term followup.
authors.affiliation: Consultant, Hand and Orthopaedic Reconstruction Surgeon, Department of Hand Surgery, Ratna Memorial Hospital, Pune, Maharashtra, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Jindal
keywords: External fixator; Phalanges of finger; giant cell tumor; giant cell tumors; hand; metacarpal bones; metacarpal loss; proximal phalanx; synostosis