Vascularized volar cutaneous flap from the ablated digit to simultaneously address first web contracture in radial polydactyly

Abstract

arthritis and include arthrodesis or excision of the fifth CMC joint. Our patient had no arthritis, and thus the fifth CMC joint could be preserved in order to maintain the transverse carpal arch and preserve some movement for cupping of the hand. Fusing the fifth to fourth metacarpal eliminated the hypermobility of the fifth CMC joint by limiting it to the normal movement of the fourth. This also eliminated intraoperative difficulties with ensuring satisfactory rotation, alignment, and length of the fifth metacarpal, which has been reported with the other procedures. General anaesthesia was chosen as a preference by the patient. The use of local or regional anaesthesia may have provided additional information. This case demonstrates the importance of examining adjacent joints when dealing with cases of instability.