Combined radius and ulna reconstruction with a free fibula transfer.
A 20-year-old man sustained a high energy injury to his right forearm resulting in comminuted open fractures of the forearm with 6 cm bone loss of the radius and 7 cm bone loss of the ulna. A bone segment was removed from the middle of a free fibula transfer to produce a single flap with two vascularised bone segments to reconstruct both the radius and ulna defects. Step osteotomies were stabilised with a single lag screw for each fracture line and, with a rigid external fixation device on the ulna, two vein grafts were used to anastomose the flap pedicle to the recipient vessels in the forearm. The postoperative period was uneventful. X-rays and scintigrams confirmed good healing of the fractures and normal perfusion of the flap so that the external fixation device could be removed 3 months after surgery. One year after the injury, the patient underwent a functional evaluation showing excellent results with very good preservation of rotation of the forearm.
Santanelli
F
F
Department of Plastic and Reconstructive Surgery, University of Rome "La Sapienza", Italy.
Latini
C
C
Leanza
L
L
Scuderi
N
N
D000328:Adult; D005360:Fibula / Q000637:transplantation; D018460:Fractures, Comminuted / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D009068:Movement; D011885:Radius Fractures / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*