Bone Loss After Implant Removal.

This case illustrates the complex challenges of managing forearm trauma complicated by bone loss after implant removal. A long-standing radial shaft plate, integrated into cortical bone with overgrowth, had to be removed to treat a new peri-prosthetic fracture. Removal caused massive cortical loss, leaving poor bone stock for fixation. Dual plating was performed to bridge the defect and stabilize the distal radius fracture, but mechanical failure prompted a staged revision. A deliberately delayed second operation allowed time for biological preparation. Definitive reconstruction included corrective osteotomy, fixation with appropriate implants, and allograft augmentation, ultimately restoring alignment, stability, and function.