Reconstruction of post-osteomyelitis 1st ray phalangeal loss with local trans positional flap and fibula bone grafting: A rare case report

Abstract Osteomyelitis is defined as infection of the bone and its marrow. It is more common in children due to growing bones and rich blood supply. Although long tubular bones are most common to get involved, no bone is exempted from acute hematogenous osteomyelitis and metatarsals account for 2% of all cases of acute hematogenous osteomyelitis. We are presenting a rare case of Community Aquired-Methicillin Resistant Staphylococcus Aureus (CA-MRSA) osteomyelitis of great toe with complete sequestration of proximal phalanx in an adolescent managed with reverse dermis cross-toe flap and inter-positional fibular grafting. On the basis of our experience with this case, we also conclude that post infective phalangeal loss with significant soft tissue necrosis does not necessarily entails amputation. With a staged soft tissue coverage and bone loss management, a good clinical, cosmetic and functional outcome can be achieved.