Combined radius and ulna reconstruction with a free fibula transfer

• Published in: British journal of plastic surgery Vol. 49; no. 3; pp. 178 - 182
• Main Authors: Santanelli, F., Latini, C., Leanza, L., Scuderi, N.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Elsevier Ltd 01.04.1996; Elsevier
• Subjects: Adult; Biological and medical sciences; Fibula - transplantation; Fractures, Comminuted - surgery; Fractures, Open - surgery; Humans; Male; Medical sciences; Movement; Orthopedic surgery; Radius Fractures - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps - methods; Treatment Outcome; Ulna Fractures - surgery; Human; Radius; Ulna; Osteoplastic flap; Fibula; Diseases of the osteoarticular system; Comminuted fracture; Male; Anatomical reconstruction; Trauma; Vascularization; Case study; Autograft; Treatment; Open fracture; Surgery; Transfer; Adult; Technique
• ISSN: 0007-1226; 1465-3087
• DOI: 10.1016/S0007-1226(96)90222-2

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.