“Recycling Technique” for Single-Stage Metacarpal Hand Reconstruction
DOI:
https://doi.org/10.15417/issn.1852-7434.2025.90.6.2027Keywords:
Transmetacarpal amputation, hand reconstruction, toe-to-hand transferAbstract
Introduction: We present an innovative surgical technique for reconstructing a metacarpal hand following transmetacarpal amputation. The procedure consists of lengthening the fourth ray using the second metatarsal as a non-vascularized bone graft to create a functional opposition post, complementing a second-toe transfer to the hand. This approach allows reconstruction of a metacarpal hand in a single surgical stage and with a single toe transfer, thereby avoiding complications associated with additional bone-graft donor sites. We also describe the functional and aesthetic outcomes obtained in our sole case to date. No published reports of a similar technique were identified.
Conclusions: Harvesting the metatarsal from the donor toe facilitates improved closure of the intermetatarsal space with a lower risk of donor-site complications, while also providing a non-vascularized bone graft that serves as an opposition mass for the transferred toe. This simplifies the surgical procedure and reduces the risk of complications.
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