Traumatic destruction of the first carpometacarpal joint is potentially devastating to hand function. We report the successful use of a nonvascularized metatarsal bone graft to reconstruct the first metacarpal head and the majority of its shaft following a gunshot wound. His hand injury consisted of a severely comminuted first metacarpal with significant bone loss including the base and proximal articular surface of the bone. The third metatarsal was harvested including the head and majority of the shaft using an oscillating saw and fixation was undertaken using crossed Kirshner wires and circlage wires. Periosteum and thenar musculature were wrapped around the bone graft to augment vascularity, accepting ultimate pseudoarthrosis. Post-operative x-rays at four months demonstrated satisfactory union which correlated with good clinical function. A formal hand rating at four and twelve months demonstrated good range of motion in flexion, abduction and opposition. Grip strength, key pinch and tip pinch demonstrated relative weakness compared to the contralateral unaffected hand, but were nevertheless adequate for satisfactory function. The patient returned to work as a church organist three months post-operatively. He had no gait disturbance or complaints referable to the foot donor site. He has remained pain free.