The management of nonunion of the forearm bones is a challenging task. Multiple factors have been associated with the establishment of forearm nonunion, such as the fracture position and complexity, general condition of the patient, and the previously utilized surgical technique. The optimal surgical treatment of a bone gap remains a subject of discussion. Autogenous corticocancellous bone grafts and vascularized bone flaps have been used with differing results. The authors describe a technique for the treatment of posttraumatic nonunion of the radius with a 5-cm bone gap using the free anterolateral thigh fascial flap wrapped around a tricortical iliac bone graft. The fracture healed after 5 weeks. The use of a vascularized tissue wrapped around the bone graft resulted in a well-healed bone and no signs of resorption after 2 years of follow-up. A bone graft wrapped by a fascial flap could magnify the restorative effect on the bone defect because of its dual role of constructing vascularization and inducing tissue regeneration.
From the *Division of Plastic and Reconstructive Surgery (M.C., D.S.) and †Division of Orthopedics and Traumatology (M.R., A.F., P.C.), Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy.
Received for publication August 16, 2016; accepted October 7, 2016.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.
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Mario Cherubino, MD, Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Ospedale di Circolo e Fondazione Macchi, Viale Borri 57, Varese, 21100, Italy, E-mail: firstname.lastname@example.org
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