One-Bone Forearm Reconstruction Procedure as Salvage Operation After Severe Upper Extremity Trauma: A Case Report

An industrial worker in his early 20s sustained a severe injury to the right dominant upper extremity: fracture, inversion, and complete devascularization of the ulna; transection of the median nerve, the radial artery, and almost all flexor tendons of the hand and fingers; loss of all extensor muscles; and transection of the biceps and brachialis muscles at the elbow. Treatment consisted of conversion to one-bone forearm, immediate reconstruction of the biceps and brachialis muscles and of all flexor tendons of the hand, repair of the radial artery and median nerve and late tendon transfer for extension of the wrist and fingers. Two and a half years after injury, the patient had full flexion and extension of the elbow, full extension but limited flexion of the wrist, and full flexion and extension of the fingers.