Radiocarpal Joint Reconstruction with a Double Free Metatarsophalangeal Joint Transfer

Plast Reconstr Surg Glob Open. 2023 Sep 28;11(9):e5284. doi: 10.1097/GOX.0000000000005284. eCollection 2023 Sep.

Abstract

Background: Destruction of the radiocarpal and midcarpal joints causes loss of wrist motion, pain, and reduced grip strength. A novel technique for radiocarpal reconstruction is presented.

Methods: Two patients who had radiocarpal and midcarpal destruction and osteoarthritis underwent reconstruction using simultaneous bilateral microvascular second metatarsophalangeal joint transfer. The insetting was performed, inverting the distal-proximal orientation of both metatarsophalangeal joints and fixing them with two 2.0 screws in proximal and Kirschner wires in distal.

Results: Radiocarpal extension and flexion without pain were preserved after a minimum of 4 years follow-up. Both patients could return to recreational activities. No secondary procedures were needed.

Conclusions: This technique could be an alternative for radiocarpal reconstruction, although longer follow-up and more cases are needed.