PMC5079429_01
Pre-operative Data A: Pre-operative x-ray of the left hand demonstrating traumatic loss of the ring and long finger MCP joints; B, C: Intra-operative photograph representing the extent of soft tissue and joint loss.
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F1
This resulted in loss of the MCP joints and associated flexor/extensor tendons of the ring and long fingers (Figure 1).
Vascularized Pedicled Joint Transfer A: Intra-operative photograph demonstrating the ring finger PIP pedicled transfer to the long finger MCP joint; B: Intra-operative photograph verifying under fluoroscopy appropriate fixation of the transferred PIP joint from the ring finger to the MCP joint of the long finger
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F2
Skin flaps were elevated at the level of the PIP joint while avoiding the ulnar-sided neurovascular supply to the joint (Figure 2). Fluoroscopy confirmed longitudinal alignment (Figure 2).
Intra-operative skin closure of the filet flap with matching of glabrous and non-glabrous skin
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F3
This matched glabrous and non-glabrous skin on the volar and dorsal aspects, respectively (Figure 3).
Six-weeks post-operative photos from the tenolysis surgery with arc of motion
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F4
He was able to oppose his thumb to his long finger (Figure 4).