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Murthy et al. Plast Aesthet Res 2020;7:64 I http://dx.doi.org/10.20517/2347-9264.2020.72 Page 9 of 13

Figure 6. Following thorough extensive debridement of non-vitalized tissues and bone resulting in large wound with exposed bony
defects, carpal instability, and extensor tendon loss

Figure 7. Arthrodesis of carpometacarpal, midcarpal, and radiocarpal joints with dual plate fixation for control of unstable carpal bones
and distal radial fracture. Hardware seen on thumb metacarpal was present from previous injury

that was transferred from the right side to the left dorsal wrist and hand and covered with a split thickness
skin graft [Figure 8].

At the same time, he underwent first stage extensor tendon reconstruction of the EPL and common
extensors to the index through small fingers, using three silicone tendon implants (one secured to the distal