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michellelgrd

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dx: segmental bone loss proximal phalanx

procedure:

iliac crest contour bone graft of proximal phalanx index finger
currettage & debridement of malunion, proximal phalanx
intramedullary bone grafting
open reduction internal fixation left index

summary:

the extensor tendon was brought up, contoured and shaped in appropriate position. Once the extensor was nicely contoured the defect was curretted from its non-union. The iliac crest was approached. A large cortical and cancellous bone graft was then brought through the margin of the index and packed within the concomitant defect. Once the cortical and cancellous defect was secured nicely to within the medullary canal a dorsal buttress place was fashioned over it. It with a series of driling and depth gauge measuring to the buttress plate was applied.

The extensor tendon was then repaired over the plate and screw fixation. The iliac crest was closed primarily with a deep stitch, followed by sterile clips and a hypafix bandage and tape.
 
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