LAUSR

SUMMARY Total finger joint reconstruction is challenging. Vascularized toe joint transfer is currently used for reconstruction, but it is difficult to perform, fails to achieve maximal joint flexibility, and is associated with donor site complications. As an alternative, we developed a vascularized medial femoral condyle flap technique, wherein the vascularized cortico-periosteum is shaped via origami, folding the donor tissue to fit the recipient site. Herein, we describe the use of this method for reconstruction of interphalangeal and metacarpophalangeal joints with a reduced range of motion. In our study, the mean age of the patients (three men, four women) was 51 years (range, 36-68 years), and the mean follow-up period was 3 years and 1 month (range, 4 months to 5 years). In the reconstructed joints, the mean range of motion; disabilities of the arm, shoulder, and hand score; and pinch strength of the unaffected side were 55° (range, 24°-90°), 2.3 (range, 0-6), and 98% (range, 70%-138%), respectively. No donor site morbidities were observed. Radiography and computed tomography revealed joint-like grafted tissue remodeling. The study findings suggest that the origami medial femoral condyle flap is useful for functional finger joint reconstruction. The procedure requires fabrication before grafting, but tissue harvest is relatively easy.Level of Evidence: Therapeutic Level IV.