To investigate the clinical efficacy of repairing complex defect of hand involving metacarpophalangeal joint and reconstructing the function of the metacarpophalangeal joint by application of 3D prefabricated upper limb lateral bone-skin flap combined with basal articular surface of metacarpal with pedicle transposition.

From June 2014 to December 2018, seven cases of complex defect of hand involving metacarpophalangeal joint were treated, and surgery was designed preoperatively on the 3D model which was created by using 3D technology and based on the 3D CT scanning data. To simulate surgery on computers and 3D models. Guided by the preoperative design, the functional reconstruction of metacarpophalangeal joint were repaired with basal articular surface of metacarpal with pedicle transposition in the injured hand. Bone and soft tissue defects in the hand were repaired with the upper limb lateral bone-skin flap in same-stage. The patients received actively functional rehabilitation exercise after the surgery then were followed up regularly.

All the patients were followed up one to four years and successful with complete survival of all the transplanted bone-skin flaps. The X-ray films showed good healing for the transplanted bones and basal articular surface of metacarpal at eight to 12 weeks postoperatively. The movable function and grip strength of injured hand were restored satisfactorily, and the senses of pain and touch were recovered. According to the functional assessment criteria of upper limb formulated by the Hand Surgery Branch of Chinese Medical Association, the results were excellent in four cases, good in two cases, and fair in one case, and the excellent and good rate of 85.7%. No dysfunction of the donor site of upper arm was observed. Patients were satisfied with outward appearance and function of injured hand, and then to return to work.

The method of combined operation is a highly targeted, effective way for reconstructing the function of the metacarpophalangeal joint and repairing bone and soft tissue defects simultoneously, and the outward appearance and function of injured hand are satisfactory, which provides a new technique for the repair of complex defect of hand involving metacarpophalangeal joint.