Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Discipline/Specialty (Author 1)
Orthopedic Surgery
Academic Level (Author 2)
Medical Student
Discipline/Specialty (Author 2)
Orthopedic Surgery
Academic Level (Author 3)
Faculty
Discipline/Specialty (Author 3)
Orthopedic Surgery
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Case Report
Abstract
Background: Finger reconstruction in the aftermath of severe trauma poses significant challenges in restorative surgery, particularly when addressing extensive soft tissue damage, comminuted fractures, and simultaneous neurovascular complications. This study presents a case of a patient with a complicated distal phalangeal fracture that pursued digit salvage.
Case Presentation: Patient is a 31-year-old woman who sustained a severe injury to her right 5th digit during an ATV rollover. The trauma resulted in an exposed and comminuted fracture of the proximal phalanx with associated loss of soft tissues, flexor tendon, radial nerve injury, and vascular compromise. She elected to pursue digit salvage despite the high risk of failure and complication. The patient underwent 4 operations over a 6-month period.
The first operation on the same day consisted of extensive I+D, ORIF of the proximal phalanx fracture, and application of an Integra Skin Graft over the salvageable flexor tendon. The skin graft failed to take and a cross-finger flap coverage was done 24 days later. The wound was complicated by a small yet deep opening which required a 3rd operation 26 days later that consisted of a division of the pink, viable skin flap. The 4th and final operation was a simultaneous distal radius corticocancellous autograft placement and PIP joint arthrodesis 4 months later due to tender proximal phalanx malunion and PIP joint nonunion.
Conclusion: This case illustrates the complex and challenging nature of finger reconstruction. Through multiple surgeries we were able to achieve the goal of successfully salvaging the finger, resolving the patient’s pain, and providing her with an aesthetically pleasing result. While the patient still has stiffness and reduced motion at the MCP, she is almost able to have a closed fist. This illustrates the importance of patient involvement in the decision-making process and making decisions on a case-by-case basis.
Recommended Citation
Franco, Emmanuel; Ayas, Zayd; and Gerold, Frank, "Staged Reconstruction and Salvage of 5th Finger With Corticocancellous Distal Radius Autograft: A Case Report" (2025). Research Symposium. 63.
https://scholarworks.utrgv.edu/somrs/2025/posters/63
Staged Reconstruction and Salvage of 5th Finger With Corticocancellous Distal Radius Autograft: A Case Report
Background: Finger reconstruction in the aftermath of severe trauma poses significant challenges in restorative surgery, particularly when addressing extensive soft tissue damage, comminuted fractures, and simultaneous neurovascular complications. This study presents a case of a patient with a complicated distal phalangeal fracture that pursued digit salvage.
Case Presentation: Patient is a 31-year-old woman who sustained a severe injury to her right 5th digit during an ATV rollover. The trauma resulted in an exposed and comminuted fracture of the proximal phalanx with associated loss of soft tissues, flexor tendon, radial nerve injury, and vascular compromise. She elected to pursue digit salvage despite the high risk of failure and complication. The patient underwent 4 operations over a 6-month period.
The first operation on the same day consisted of extensive I+D, ORIF of the proximal phalanx fracture, and application of an Integra Skin Graft over the salvageable flexor tendon. The skin graft failed to take and a cross-finger flap coverage was done 24 days later. The wound was complicated by a small yet deep opening which required a 3rd operation 26 days later that consisted of a division of the pink, viable skin flap. The 4th and final operation was a simultaneous distal radius corticocancellous autograft placement and PIP joint arthrodesis 4 months later due to tender proximal phalanx malunion and PIP joint nonunion.
Conclusion: This case illustrates the complex and challenging nature of finger reconstruction. Through multiple surgeries we were able to achieve the goal of successfully salvaging the finger, resolving the patient’s pain, and providing her with an aesthetically pleasing result. While the patient still has stiffness and reduced motion at the MCP, she is almost able to have a closed fist. This illustrates the importance of patient involvement in the decision-making process and making decisions on a case-by-case basis.
