{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:50Z","timestamp":1756339550782,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,10]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Acute lower limb trauma with bone loss is an uncommon occurrence. Injuries of this nature typically result from high-energy trauma and can result in significant functional impairment, with the potential for amputation.<\/jats:p>\n               <jats:p>Nonetheless, it is recommended that salvage reconstructive procedures be attempted whenever feasible in the context of an emergency and even in cases of severe injury. Good outcomes may be achieved with creative solutions, as illustrated by this rare and particular case.<\/jats:p>\n               <jats:p>We present an acute reconstructive solution involving the transposition of a foot ray and interposition of an autogenous phalangeal bone graft of a resected ray in a severe foot injury. At the 1\u2009year follow-up, the patient exhibited symmetrical range of motion of the foot and ankle, full weight bearing and the ability to walk without external aids. This treatment modality demonstrates its efficacy in addressing severe bone defects, offering the prospect of positive functional outcomes and facilitating psychosocial adaptation.<\/jats:p>","DOI":"10.1136\/bcr-2024-264134","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:30:55Z","timestamp":1742956255000},"page":"e264134","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Metatarsal transposition with interposition of autogenous structural graft of the phalanx as a reconstructive solution in severe traumatic injuries of the foot"],"prefix":"10.1136","volume":"18","author":[{"given":"Goncalo","family":"Modesto","sequence":"first","affiliation":[{"name":"Orthopaedics, ULS Coimbra, Coimbra, Portugal"},{"name":"Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediatrico de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9349-2483","authenticated-orcid":false,"given":"Marcos","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Paediatric Orthopaedics, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediatrico de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9270-4536","authenticated-orcid":false,"given":"Pedro S\u00e1","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Paediatric Orthopaedics, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediatrico de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Paediatric Orthopaedics, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediatrico de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"2025082710132731000_18.3.e264134.1","unstructured":"Skeletal trauma: basic science, management, and reconstruction, 2-volume set. 5th edn."},{"key":"2025082710132731000_18.3.e264134.2","doi-asserted-by":"crossref","first-page":"334","DOI":"10.3109\/10582452.2013.851761","article-title":"Quality of Life in Patients with Lower Limb Amputation: Does It Affect Post-amputation Pain, Functional Status, Emotional Status and Perception of Body Image?","volume":"21","author":"Akyol","year":"2013","journal-title":"J Musculoskelet Pain"},{"key":"2025082710132731000_18.3.e264134.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.11.003"},{"key":"2025082710132731000_18.3.e264134.4","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1007\/s00402-020-03562-9","article-title":"Functional outcome and complications after treatment of comminuted tibial fractures or deformities using Ilizarov bone transport: a single-center study at 15- to 30-year follow-up","volume":"141","author":"Biz","year":"2021","journal-title":"Arch Orthop Trauma Surg"},{"key":"2025082710132731000_18.3.e264134.5","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/6054021","article-title":"Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques","volume":"2018","author":"Biz","year":"2018","journal-title":"Biomed Res Int"},{"key":"2025082710132731000_18.3.e264134.6","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1097\/01.PRS.0000138811.88807.65","article-title":"One-stage reconstruction of composite bone and soft-tissue defects in traumatic lower extremities","volume":"114","author":"Yazar","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"2025082710132731000_18.3.e264134.7","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1055\/s-0042-1757322","article-title":"Sensory and Functional Recovery after Suprafascial Free Flap in Foot and Ankle Reconstruction","volume":"08","author":"Akaranuchat","year":"2023","journal-title":"J Reconstr Microsurg Open"},{"key":"2025082710132731000_18.3.e264134.8","unstructured":"Senk A , Schwanz KL , Wundrach D , et al . Ankle and foot neuropathies & entrapments. PM&R KnowledgeNow, 2015."},{"key":"2025082710132731000_18.3.e264134.9","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.fcl.2011.01.012","article-title":"Electrodiagnostic evaluation of lower extremity neurogenic problems","volume":"16","author":"Roy","year":"2011","journal-title":"Foot Ankle Clin"},{"key":"2025082710132731000_18.3.e264134.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2009.11.005"},{"key":"2025082710132731000_18.3.e264134.11","doi-asserted-by":"crossref","first-page":"67","DOI":"10.29337\/ijops.14","article-title":"Metatarsal Bone Transposition as an Innovative and Alternative Salvage Procedure for Complex Foot Injuries: A Case Report","volume":"1","author":"Cigna","year":"2018","journal-title":"Int J Orthop Surg"},{"key":"2025082710132731000_18.3.e264134.12","article-title":"Limb Salvage vs. Amputation: Factors Influencing the Decision-Making Process and Outcomes for Mangled Extremity Injuries","volume":"14","author":"Beeharry","year":"2022","journal-title":"Cureus"},{"key":"2025082710132731000_18.3.e264134.13","first-page":"19","article-title":"Partial foot amputations in the combat wounded","volume":"20","author":"Kirk","year":"2011","journal-title":"J Surg Orthop Adv"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:13:33Z","timestamp":1756314813000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,25]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bcr-2024-264134"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264134","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}