Reconstruction of a complicated adjacent non-union of the radius and ulna using a free vascularised double-barrel fibula graft.

While the free vascularised double-barrel fibula flap has been traditionally used in the reconstruction of defects in the long bones of the lower extremities, the advantages of this type of graft can also be seen in the treatment of adjacent radial and ulnar non-unions of the forearm. The main advantage of the double-barrel fibula flap in treatment of antebrachial non-unions is that it allows for the simultaneous anatomical reconstruction of the radius and the ulna while maximising forearm functionality. In contrast to other procedures, this tailored graft also helps preserve pronation and supination of the forearm. In this article, we chronicle a case in which a microvascular osteomyocutaneous double-barrel fibula flap was used to concurrently reconstruct the radius and ulna of a patient with a severe antebrachial non-union.