Keywords
Bone defect
Non-vascularized fibular graft
Bone reconstruction
Autograft, Case report
How to Cite
Abstract
Background: Open fractures of the forearm with segmental bone loss represent one of the greatest challenges in reconstructive orthopedics due to the anatomical and functional complexity of the radius and ulna. Non-vascularized fibula grafting (NVFG) has been proposed as an effective alternative in moderate bone defects, especially in services without microsurgery availability, presenting good consolidation rates and lower morbidity when compared to more complex techniques.
Aim: To report and critically analyze a case of segmental radius defect reconstruction with a non-vascularized fibula graft in a young patient who was the victim of high-energy trauma, followed up for 24 months.
Method: Case report study based on a retrospective review of hospital records and imaging exams. Clinical, surgical, and functional data were evaluated for a patient treated at a university hospital, with two years of outpatient follow-up.
Case Report: A 25-year-old female patient, victim of a car accident, presented with an open fracture of the radius and ulna with a 5 cm radial segmental defect. Initially, she underwent surgical cleaning, antibiotic therapy, and external fixation. Subsequently, reconstruction was performed with a 6 cm non-vascularized autologous fibula graft, fixed with a DCP plate. The evolution was favorable, with signs of bone integration in eight weeks, callus formation in six months, and complete consolidation in 12 months. After 24 months, the patient had preserved function, near-normal pronation-supination range of motion, and return to activities of daily living.
Conclusion: Non-vascularized fibula grafting proved to be a safe, effective, and viable alternative for reconstruction of segmental forearm defects in a hospital setting without microsurgery available. The case reinforces its applicability as a cost-effective technique, with good long-term consolidation and function results, provided there is adequate patient selection, careful surgical technique, and rigorous follow-up.
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