Successful reconstruction of a gunshot segmental defect of the radius with a free vascularised fibular osteocutaneous flap

SummaryThe use of the vascularised fibular flap for bony reconstruction was first described for the mandible. It has since been used for upper limb bony defects of various aetiologies (congenital, infective, traumatic and neoplastic). Specifically gunshot segmental defects of the upper limb have been reconstructed with vascularised fibular in the humerus and radius, the common indication in these previous cases was delayed reconstruction. We describe a challenging case of a 40-year-old male with a 6.5 cm segmental radial defect caused by gunshot wounds, which was primarily reconstructed using this microvascular technique. The advantages of the vascularised fibular flap and its suitability for this type of reconstructive surgery are discussed.