Use of Single Iliac-Bone Graft to Replace Multiple Metacarpal Loss in Dorsal Injuries of the Hand

¹ DES MOINES, IOWA

Reconstruction of two damaged hands was carried out in stages: (1) pedicle-skin grafting, (2) bone-grafting, and (3) tendon-grafting (in the second case only). In both patients, the lost metacarpals were replaced by single blocks of iliac bone, tailored to fit the size of the existing defect in the bone framework of the hand. When last seen, both patients had useful stable hands and were able to engage in many normal activities.

The natural curve of the ala ossis ilii corresponds to the concavity of the palm, and its thickness is suitable for metacarpal replacement. When either three adjacent or all four metacarpals have been destroyed, large single grafts of this type are technically easier to apply and are more stable than are multiple struts inserted to replace individual metacarpals.

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