Repair of open humerus fracture and extensive bone defect using bone grafting (case report)

Introduction Treatment of a patient with an open comminuted humerus fracture and an extensive bone defect is challenging and associated with high risk of a poor outcome, infection resulting from skin and soft tissue injury and considerable bone transport. The objective of the study is to demonstrate the experience with an open comminuted humerus fracture and an extensive bone defect treated with staged use of transosseous fixation with rod-and-wire device, autologous fibula graft and internal wiring. Material and methods We report a case of an open humerus fracture and an extensive bone defect treated with a bone replacement technique and followed up to 4 years. Results and discussion The limb was temporarily fixed with external fixation device extrafocally using wires and rods. A 24 cm autograft was harvested from the fibula. Osteosynthesis of the humerus and autografting were produced with the graft fixed using smooth wires and external fixation was provided using wires and rods. With consolidation of the humerus achieved, the external fixation device was dismantled and transosseous wires removed. Anatomical length of the segment was restored. Conclusion Combined techniques and technical means of external fixation, autologous graft, internal fixation with smooth wires facilitated complete restoration of the injured limb avoiding complications with a good clinical outcome.