Late reconstruction of two total metacarpal bone defects using lengthening devices and a double-barrel osteocutaneous free parascapular flap.

A case was presented in which the late reconstruction of left ring and little metacarpal bone defects was carried out using a lengthening device and a double-barrel osteocutaneous free parascapular flap. With this flap, up to 14 cm of nearly straight bone of a suitable width and length for the reconstruction of two metacarpal bones was raised safely. However, it required 3 months of lengthening to create enough space to insert the grafted bone because of the severe resistance of scar contracture and fibrous tissues.