Management of an Adult Open Diaphyseal Both-Bone Forearm Fracture With Severe Bone Loss: A Case Report, Literature Review, and Surgical Techniques.

Open forearm fractures involving both the radius and ulna are challenging orthopedic injuries, typically resulting from high-energy impacts. These injuries require complex surgical interventions, such as open reduction and internal fixation (ORIF) or intramedullary nailing, and often necessitate multiple approaches due to the proximity of neurovascular structures. Severe cases can lead to complications such as infection, nonunion, and functional impairment of the limb. Here, we present the case of a 42-year-old male who sustained multiple injuries in a motor vehicle accident, including an open comminuted both-bone forearm fracture with severe bone loss. The fracture was initially managed at a local hospital with external fixation before the patient was transferred to a higher-level trauma center for definitive fixation. He subsequently underwent ORIF with bone grafting due to the extent of bone loss. This case highlights surgical techniques used in the management of open forearm fractures with severe comminution and bone loss.