Metatarsal transposition with interposition of autogenous structural graft of the phalanx as a reconstructive solution in severe traumatic injuries of the foot.

Acute lower limb trauma with bone loss is an uncommon occurrence. Injuries of this nature typically result from high-energy trauma and can result in significant functional impairment, with the potential for amputation.Nonetheless, it is recommended that salvage reconstructive procedures be attempted whenever feasible in the context of an emergency and even in cases of severe injury. Good outcomes may be achieved with creative solutions, as illustrated by this rare and particular case.We present an acute reconstructive solution involving the transposition of a foot ray and interposition of an autogenous phalangeal bone graft of a resected ray in a severe foot injury. At the 1 year follow-up, the patient exhibited symmetrical range of motion of the foot and ankle, full weight bearing and the ability to walk without external aids. This treatment modality demonstrates its efficacy in addressing severe bone defects, offering the prospect of positive functional outcomes and facilitating psychosocial adaptation.