Work

Multistage microsurgical reconstruction after catastrophic shark attack: Vascularized ulnar nerve grafting for a large segmental sciatic nerve defect

Year: 2026

Type: article

Abstract: We present a 48-year-old woman who sustained life threatening polytrauma from a shark attack in New Caledonia, including posterior trunk and thigh crush-avulsion, bilateral upper-limb amputations and a 16 cm segmental sciatic nerve defect. Staged reconstruction included a free latissimus dorsi (LD) flap to the posterior thigh, a vascularized ulnar nerve graft (VUNG) for sciatic repair, a neurotized anterolateral thigh (ALT) flap for sensate hand coverage, toe-to-thumb transfer and targeted muscle reinnervation (TMR). This approach achieved functional independence and quality of life restoration. This is the first reported use of a VUNG for large segmental sciatic nerve reconstruction.

Source: JPRAS Open

DOI: 10.1016/j.jpra.2026.02.016

Authors: Jeremy Bishay, Harrison Garrett, Rowan Gillies, David Stewart, Bishoy Soliman

Institutions: Westmead Hospital, Royal North Shore Hospital

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,920