K. Arai et al., One-bone forearm formation using vascularized fibula graft for massive bone defect of the forearm with infection: Case report, J RECON MIC, 17(3), 2001, pp. 151-155
Massive long-bone defects of greater than 6 cm are difficult to treat with
conventional bone grafts, and other methods are sometimes recommended, such
as vascularized bone grafts or bone transport using the Ilizarov external
fixator. The combination of local infection with a massive bone defect exac
erbates the problem, and provides an even more negative prognosis. The auth
ors treated a large bone defect of the forearm with local infection, using
a one-bone forearm formation with a large vascularized fibula graft. They a
ttached an adequate amount of muscle fascia to the vascularized fibula, whi
ch was useful not only for coverage of the skin defect, but also for treatm
ent of the local infection. Twenty months after surgery elbow and hand func
tions were maintained, and the patient had no disturbance of hand function
in daily activities, although rotation of the forearm was sacrificed.