PMC9826546_01
(a and b) Preoperative clinical images of the patient in forearm pronation.
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F1
A 14-year-old girl presented with gradually progressive deformity of the right forearm since the past 1 year associated with mild pain (Fig. 1, 2, 3).
(a and b) Pre-operative clinical images of the patient showing forearm in supination.
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F2
A 14-year-old girl presented with gradually progressive deformity of the right forearm since the past 1 year associated with mild pain (Fig. 1, 2, 3).
(a and b) Pre-operative clinical images of the patient showing forearm in mid-prone position.
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F3
A 14-year-old girl presented with gradually progressive deformity of the right forearm since the past 1 year associated with mild pain (Fig. 1, 2, 3).
(a and b) Skeletal radiograph (frontal and lateral views) showing an expansile lytic lesion with ground glass appearance involving the proximal meta-diaphysis of the right radius, with its resultant bowing.
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F4
Skeletal radiographs (frontal and lateral view) of the right forearm revealed an expansile lytic lesion with ground glass appearance involving the proximal meta-diaphysis of the right radius, with its resultant bowing (Fig. 4a, 4b).
(a and b) Intraoperative image showing the radius bone (Henry's approach).
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F5
The lesion in the radius was explored using the Henry's approach (Fig. 5a, 5b).
(a-c) Intraoperative images showing excised lesion (a and b) along with fibular cortical graft  .
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F6
The proximal three-fourth of the radius bone was exposed and the lesion was excised along with 1 cm of normal bone on the distal side (Fig. 6a, 6b). Fibular cortical strut graft was harvested from the leg of same side (Fig. 6c).
(a and b) Intraoperative images with fibular cortical graft jammed in the defect.
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F7
The graft was beveled on the distal end and jammed into the shaft of the distal radius such that 1 cm of graft was inside the original bone (Fig. 7a, 7b).
Immediate post-operative radiographs.
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F8
Immediate post-operative radiographs were obtained (Fig. 8) and a long arm or above elbow splint was applied keeping the elbow at 90 degrees of flexion and the forearm in supination for a total of 6 months.
Radiographs of the patient (7-month follow-up).
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F9
Follow-up radiographs (Fig. 9) obtained at 7 months revealed complete incorporation of the cortical bone graft with reformation of the intramedullary bone canal and restoration of hand and elbow function (Fig. 10a-c).