FIBULA OSTEOSEPTOCUTANEOUS FREE FLAP GRAFTING IN PATIENT WITH GUNSHOT DIAPHYSEAL DEFECTS OF FOREARM

Abstract

The authors report a case of a gunshot complex combined skeletal and soft tissue defect of the upper extremity complicated by chronical wound infection successfully treated with fibula osteoseptocutaneous free flap. A military man had sustained a gunshot-comminuted fracture and diaphyseal defect of both bones in the middle third of the right forearm fixed by Ilizarov external fixator. There also was a soft tissue defect on the radial aspect of the right forearm and persisting chronic wound process. A free vascularized osteoseptocutaneous fibula graft was harvested from the right lower extremity, prepared and inserted between radius fragments. Fixation of the graft was made by locking intramedullary nail. All wounds and the donor site healed primarily. Postoperative x-rays at 5 months demonstrated healing at both ends of the fibular graft.

Keywords

• gunshot injury
• wound process
• vascularized compound free osteoseptocutaneous fibula flap
• intramedullary fixation