The principle aim in complex defects in hand is to restore a functioning tripod pinch. Among the various options, the use of locally available spare parts offers to improve both functions and cosmetics. 10 patients underwent surgeries to restore tripod pinch using this concept of spare parts. Four of them were children with congenital differences and the rest were adults with post traumatic defects. Eight of them underwent on-top plasty out of which four underwent an island pedicled transfer of phalanges and the rest involved distraction lengthening and transfer of metacarpals. One patient underwent a vascularized tenocutaneous joint transfer and another, a non-vascularized metacarpal transfer. At last follow up, eight of them were using hand with tripod pinch and one, using a lateral pinch. A carefully planned use of local tissues as spare part results in satisfactory outcome without the need for additional graft material in hands with absent or poor function.
Keywords: Distraction; On top Plasty; Spare Parts; Tripod Pinch.