Work

Vascularized Fibula for Early Management of Upper Extremity Trauma With Critical Bone Loss: A Report of Two Cases

Year: 2026

Type: article

Abstract: Introduction: We present two Type 3B open fracture cases with critical bone loss in the upper extremity: a 9 cm ulnar defect and 8.5 cm distal humerus defect treated with vascularized fibula graft 6 and 21 days postinjury, respectively. Both patients had complete healing of soft tissues, no known complications, and returned to heavy duty labor within 3 and 5 months of injury. Although the use of vascularized fibula graft is well described, the novelty of our cases lies in its use as the initial attempt at definitive fixation of acute upper extremity trauma with critical bone loss, rather than as a salvage procedure following nonunion or infection. Conclusion: Critical bone loss following upper extremity trauma is rare and challenging. The vascularized fibula graft is ideal for these cases and should be considered for acute, single-stage reconstruction of traumatic upper extremity bone defects to achieve maximal outcomes in the shortest time.

Source: Case Reports in Orthopedics

DOI: 10.1155/cro/2860926

Authors: Brian Chen, Lindsey Herrod, Mayo Hotta, Jorge L. Rocha, Martin I. Newman, James W. Fletcher

Institutions: Cleveland Clinic Florida, Broward Health Medical Center

Language: English

Topic: Bone fractures and treatments

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $790