Introduction - Post traumatic complex defects of the forearm require multiple operations and prolonged rehabilitation. Segmental bony defects of the radius and ulna are occasionally seen as part of these complex wounds. There are a few options in bridging the skeletal defect. These include corticocancellous bone grafting, creation of a one bone forearm and vascularised fibula. Vascularised bone grafting is superior in an ischemic and fibrosed area as it enhances local blood supply. The fibula is usually used to bridge the defect in one bone i.e. the radius.
Case presentation – A young male presented with an open comminuted fracture of radius and ulna following a crush injury to the left upper limb. The reconstruction was done in two stages – first a pedicled thoracoumbilical flap for soft tissue and in later stage a double barrel free fibula flap for segmental bone loss.
Conclusion – The above approach offered the best chance of skeletal healing in a complex defect. The patient was able to gain reasonably good upper extremity function with the described technique.