DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.002

Pages: 2668-2671

We present the case of a 26-year-old male patient with a septic nonunion of P1 of the left third finger following a neglected open fracture, with a chronic skin opening. Management was carried out in two surgical stages. The first stage consisted of extensive surgical debridement, sequestrectomy, and the placement of an antibiotic-loaded cement spacer in the bone defect. After 6 weeks of targeted antibiotic therapy and confirmation of infection eradication, a second reconstructive stage was performed. This involved a cancellous iliac bone graft to fill the bone defect, stabilized by osteosynthesis with 2 Kirschner wires, and an antegrade dorsal metacarpal flap to cover the skin defect and provide local vascularization. The postoperative course was uneventful, with complete bone and skin healing at 3 months, and satisfactory functional recovery at 6 months of follow-up.