title: Finger reconstruction using induced membrane technique and ulnar pedicled forearm flap: a case report.
abstract: BACKGROUND
  Injuries referred to as "rollover hands" are associated with multiple and complex lesions of the dorsal aspect of the hand. We present a case of a multitissular reconstruction following a severe injury of the dorsum of the fingers in a 45-year-old woman.
  
  
  METHODS
  The bone loss reconstruction was performed in two stages using the Masquelet induced membrane technique. In the first stage, a cement spacer was inserted into the phalanx bone defects. For the second stage, the membrane induced by the foreign-body reaction was opened, the spacer was removed, and an autologous cancellous bone graft was inserted into the defects. The skin coverage was obtained using a reverse ulnar artery forearm pedicled flap. The digits were covered jointly. Three surgical procedures over the course of a 2-month period were required to desyndactylize the fingers and to defat the flap.
  
  
  RESULTS
  At the 2-year follow-up examination, the patient exhibited good integration of their hand use in daily living. The esthetic result was deemed to be satisfactory. Definitive bone consolidation occurred 4 months after the second stage.
  
  
  CONCLUSIONS
  Rollover hands are typically a challenge for both the patient and the hand surgeon. The risk of septic complications, as well as the need for several stages of surgical reconstruction, makes the Masquelet technique particularly attractive for the treatment of phalanx bone defects consecutive to rollover injuries.
authors.affiliation: Orthopaedic, Trauma, and Hand Surgery, Saint Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Herisson
authors.affiliation: Orthopaedic, Trauma, and Hand Surgery, Saint Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.|Université Pierre et Marie Curie Paris 6, 4 place Jussieu, 75005, Paris, France.
authors.forename: Alain-Charles
authors.initials: AC
authors.lastname: Masquelet
authors.affiliation: Orthopaedic, Trauma, and Hand Surgery, Saint Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.|Université Pierre et Marie Curie Paris 6, 4 place Jussieu, 75005, Paris, France.
authors.forename: Levon
authors.initials: L
authors.lastname: Doursounian
authors.affiliation: Orthopaedic, Trauma, and Hand Surgery, Saint Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.|Université Pierre et Marie Curie Paris 6, 4 place Jussieu, 75005, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Sautet
authors.affiliation: Orthopaedic, Trauma, and Hand Surgery, Saint Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France. Adeline_cambon@yahoo.fr.|Université Pierre et Marie Curie Paris 6, 4 place Jussieu, 75005, Paris, France. Adeline_cambon@yahoo.fr.
authors.forename: Adeline
authors.identifier: http://orcid.org/0000-0003-1871-4493
authors.initials: A
authors.lastname: Cambon-Binder
mesh_terms: D000063:Accidents, Traffic; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000601:surgery; D005542:Forearm / Q000601:surgery; D006230:Hand Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011859:Radiography / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Bone reconstruction; Induced membrane technique; Masquelet technique; Rollover hand; Ulnar artery forearm flap