Case report: Novel approach to distal radius non-union treatment with free fibula flap reconstruction.

INTRODUCTION

Distal radius fractures are common among adults. Despite being a rare complication, occurring in only 0.2 % of the cases, non-union poses significant treatment challenges.

PRESENTATION OF CASE: In this article, we report the case of a 43-year-old male with a history of distal radius fracture resulting from a motorcycle accident. His initial treatment consisted of external fixation followed by a distraction plate and internal fixation with volar plate and screws. Due to plate breakage, he underwent refixation with a volar plate and autologous bone graft six months after the accident. However, five months after surgery, CT-scans showed a radius non-union. This led to a multidisciplinary approach involving orthopaedic and plastic surgery teams, where the patient underwent distal radius reconstruction using a free fibula flap. Postoperative recovery led to favourable outcomes with evidence of bony consolidation at six-month follow-up.

DISCUSSION: Conventional techniques for distal radius non-union treatment may fall short in achieving bony continuity in a non-suitable soft tissue environment. Free vascularised fibular flap has emerged as a primary option for long bone reconstruction, offering advantages such as anatomical compatibility and immediate structural support.

CONCLUSION

This case highlights the efficacy of free fibular flap in addressing complex distal radius non-unions, providing an effective solution when simpler techniques have failed.