Case report: Novel approach to distal radius non-union treatment with free fibula flap reconstruction.

Introduction: Distal radius fractures are common among adults. Despite being a rare complication, occurring in only 0.2 % of the cases, non-union poses significant treatment challenges.

Presentation of case: In this article, we report the case of a 43-year-old male with a history of distal radius fracture resulting from a motorcycle accident. His initial treatment consisted of external fixation followed by a distraction plate and internal fixation with volar plate and screws. Due to plate breakage, he underwent refixation with a volar plate and autologous bone graft six months after the accident. However, five months after surgery, CT-scans showed a radius non-union. This led to a multidisciplinary approach involving orthopaedic and plastic surgery teams, where the patient underwent distal radius reconstruction using a free fibula flap. Postoperative recovery led to favourable outcomes with evidence of bony consolidation at six-month follow-up.

Discussion: Conventional techniques for distal radius non-union treatment may fall short in achieving bony continuity in a non-suitable soft tissue environment. Free vascularised fibular flap has emerged as a primary option for long bone reconstruction, offering advantages such as anatomical compatibility and immediate structural support.

Conclusion: This case highlights the efficacy of free fibular flap in addressing complex distal radius non-unions, providing an effective solution when simpler techniques have failed.