Background: Neurofibromatosis type 1 is a hereditary disease that can lead to pseudoarthrosis of various long bones. Rarely, pseudoarthrosis affects the forearm, and to the best of our knowledge, this is the first reported case of pseudarthrosis of the distal radius treated by this unique method. Methods: We present a case of a 7-year-old male who underwent multiple operations to treat pseudoarthrosis of the distal radius. Results: After failed conservative and operative fixation augmented with autologous iliac crest bone grafting, the patient underwent a successful double-barrel vascularized free fibula graft while preserving the physis of the distal radius. Conclusion: Double-barrel vascularized free fibula bone graft can be successfully used as the definitive treatment in refractory cases of distal forearm pseudarthrosis and we believe that our technique can be applied to all cases of pseudarthrosis in other patients with a similar presentation and lesion location.
AllieuYMeyerzuReckendorfGChammasMGomisR.Congenital pseudarthrosis of both forearm bones: long-term results of two cases managed by free vascularized fibular graft. J Hand Surg Am. 1999;24:604-608.
2.
BauerASSinghAKAmanatullahDLermanJJamesMA.Free vascularized fibular transfer with langenskiold procedure for the treatment of congenital pseudarthrosis of the forearm. Tech Hand Up Extrem Surg. 2013;17:144-150.
3.
BellDF.Congenital forearm pseudarthrosis: report of six cases and review of the literature. J Pediatr Orthop. 1989;9:438-443.
4.
BoydHBFoxKW.Congenital pseudarthrosis; follow-up study after massive bone-grafting. J Bone Joint Surg Am. 1948;30A:274-283.
5.
BrownGAOseboldWRPonsetiIV.Congenital pseudarthrosis of long bones: a clinical, radiographic, histologic and ultrastructural study. Clin Orthop Relat Res. 1977;128:228-242.
6.
CrawfordAHJrBagameryN.Osseous manifestations of neurofibromatosis in childhood. J Pediatr Orthop. 1986;6:72-88.
7.
ManskePR.Forearm pseudarthrosis—neurofibromatosis: case report. Clin Orthop Relat Res. 1979;139:125-127.
8.
MathoulinCGilbertAAzzeRG.Congenital pseudarthrosis of the forearm: treatment of six cases with vascularized fibular graft and a review of the literature. Microsurgery. 1993;14:252-259.
9.
OlekasJGuobysA.Vascularised bone transfer for defects and pseudarthroses of forearm bones. J Hand Surg Br. 1991;16:406-408.
10.
WitoonchartKUerpairojkitCLeechavengvongsSThuvasethakulP.Congenital pseudarthrosis of the forearm treated by free vascularized fibular graft: a report of three cases and a review of the literature. J Hand Surg Am. 1999;24:1045-1055.
