Non-vascularized large free fibular bone graft in post- traumatic and infectious ulnar bone defect: a case report


  • Kuldeep Nahar Department of Orthopaedic Surgery, Gujarat research and medical institute, Shahibagh, Ahmedabad, Gujarat, India
  • Nikita Nahar Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujarat, India



Open ulnar bone loss, Debridement, primary forearm nailing, Free fibular bone graft


This reported case is about the successful union of an adult male, having open post traumatic infected nonunion of ulna with a bone loss of ulna around 11 cm. Difficult environment around gap nonunion makes the management more difficult for bone graft to stay there. Repeated debridement and skin courage played the key role in controlling the infection. A calculated risk of putting a non-vascular 12 cm autologous fibular graft fixed with plate and screws and supported with medullary nail was taken and a successful union achieved within 4.5 months. So nonvascular free can be a choice for critical bone defects nonunion in fore bones post traumatic one also.


Pacelli LL, Gillard J, McLoughlin SW, Buehler MJ. A biomechanical analysis of donor-site ankle instability following free fibular graft harvest. J Bone Joint Surg. 2003;85:597-603.

Azi LM, Aprato A, Santi I, Kfuri M, Masse A, Joeris A. Autologous bone graft in the treatment of post-traumatic bone defects: a systematic review and meta-analysis. Brtis Med Centr musculoskelet disord. 2016;17(1):465.

Adami R, D Luca, Innocenti M, M Ignazio, Tarallo LC, Andrea et al. Reconstruction of large posttraumatic skeletal defects of the forearm by vascularized free fibular graft. Microsurg. 2004;24(6).

Stevanovic M, Gutow AB, Sharpe F. The manage ment of bone defects of the forearm after trauma. Hand Clin. 1999;15(2):299-318.

Steinlechner C, Wand M, Kandawire NC. Non-vascu- larised fibular transfer in the management of defects of long bones after sequestrectomy in children. J Bone Joint Surg. 2005;87-B:1259-63.

Tarng YW, Lin KC. Management of bone defects due to infected non-union or chronic osteomyelitis with autologous non-vascularized free fibular grafts. Injur. 2020;51(2):294-300.

Sayed M, Hadidi M, Adl W. Free non-vascularized fibular graft for treatment of post-traumatic bone defects. Acta Orthop Belg. 2007;73:70-6

Al-zahrani S, Harding MG, Kremli M, Khan FA, Ikram A, Takroni T. Free fibular graft still has a place in the treatment of bone defects. Injur. 1993;24: 551-4.