Right Ulnar Reconstruction after Sequestrectomy by Non-Vascularized Fibular Transfer in a Girl of Three Years

Abstract

Chronic osteomyelitis is serious because of the orthopedic sequels that they could cause. Extended diaphyseal sequestrations could cause bone loss and their management is delicate. Here we report a case of right ulnar diaphyseal reconstruction by non-vascularized fibula transfer. This was a three-year-old girl, non-sickle cell, who had chronic osteomyelitis of the right ulna. The evolution was towards an almost total ulnar diaphyseal sequestration with externalization of the distal extremity. The removal of this large sequestrum occurred almost spontaneously, leaving a significant bone loss over a length of about 6 cm. Secondarily, we reconstructed the right ulnar diaphysis by transfer of a free non-vascularized graft of the left fibula, maintained by a pin. The follow up was favorable with almost complete recovery of prono-supination. Fibular ossification has evolved as well and we did not notice any complications at the graft collection site. Non-vascularized fibula graft transfer is a useful therapeutic option in the management of significant bone defects secondary to chronic osteomyelitis of one of the two forearm bones.