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February 21, 2026JBJS Case Connector0 citations

Reconstruction of Radio-Lunate Articulation With Grafts From Second Metatarsophalangeal Joint Using 3D Planning

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AEAmr EisaMTMirjam ThielenLHLeila Harhaus

Key Points

  • The aim is to explore the effectiveness of 3D-planned osteochondral reconstruction in repairing the radiolunate joint using metatarsophalangeal grafts.
  • Patient-specific guides/plate for accurate graft placement
  • CT-based 3D planning for customization
  • Free, nonvascularized transfer of the second metatarsophalangeal joint
  • Evaluation using DASH score and gait analysis post-surgery
  • Wrist pain resolved completely after 1 year
  • Achieved near normal range of motion with a DASH score of 5
  • CT confirmed complete integration of the graft
  • Gait analysis showed no significant deficits at the donor site

Abstract

Case: A 12-year-old girl with post-traumatic destruction of the radiolunate joint underwent CT-based three-dimensional (3D) planning with patient-specific guides/plate and a free, nonvascularized transfer of the second metatarsophalangeal joint: the proximal phalanx base resurfaced the lunate fossa and the second metatarsal head reconstructed the lunate using Osteochondral Autologous Transfer System. At 1 year, wrist pain resolved, near normal range of motion was achieved with a DASH score of 5. CT showed complete graft integration. Gait analysis showed no clinically relevant donor-site deficit. Conclusion: 3D-planned, osteochondral reconstruction of radiolunate articulation using grafts from the second metatarsophalangeal joint can preserve motion with minimal donor morbidity in skeletally immature patients. Level of Evidence: Case report, Level V .

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Cite This Study

Eisa et al. (2026) studied this question.

synapsesocial.com/papers/69994cb3873532290d021561https://doi.org/10.2106/jbjs.cc.25.00510
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