PMC9939850_01
Interventions performed on the patient at two years of age.. A, B. X-ray after cast immobilization. C, D. X-ray after internal fixation + grafting. E, F. X-ray after electrical stimulation for one month.
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FIG1
The patient was followed up for two more months and there was no sign of union, and the rod was removed and electrical stimulation treatment was applied (Figure 1).
Evaluations and interventions when the patient reached six years of age. A, B, C. Initial evaluation X-ray and three-dimensional (3D) computed tomography images. D, E, F. X-ray images of forearm and cruris after vascularized fibula operation. G, H, I. X-ray images of forearm and cruris six months after vascularized fibula operation.
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FIG2
To prevent rotation of the distal segment, two transverse k-wires were placed just proximal to the epiphysis (Figure 2). Radiographic union was achieved in the proximal part at week 4 and in the distal part at week 7 (Figure 2).
Intraoperative images of the patient.. A. Controls of vascularized fibula graft before proximal pedicle separation. B. The resected bone segment with pseudoarthrosis. C. The appearance of the bone defect in the forearm after resection.
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FIG3
The deformed segment was completely removed using the volar Henry approach (Figure 3).
Postoperative follow-up photographs of the patient.. A. Pronation, B. neutral, C. supination, D. comparative forearm dorsal view, E. comparative forearm volar view.
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FIG4
After an 18-month follow-up, there was 1 cm of radial shortening and radial translation of the wrist, and the patient's wrist flexion-extension and pronation movements were limited to full supination at 10 degrees (Figure 4).