Reconstruction of Radius Bone Defect in a 10-Year-Old Girl with Neurofibromatosis Type I Using Association of Autograft, Elastic HA-Coated Nail, and External Fixation

NF1-associated pseudoarthrosis of the forearm is an extremely rare condition. It represents a problem for medical management and often requires surgical intervention due to poor potential for healing, high failure rates of bone union, and pathological refractures. The transfer of a free vascularized fibula seems to be more successful method. Several other surgical techniques are proposed, but the most optimal treatment strategy remains controversial especially after failure of the index surgery. This is a case of large radial defect management with combined technique (Ilizarov method, fibular grafting, and elastic hydroxyapatite-coated nailing). Previous multiple surgeries failed to unite and even resulted in subtotal radial defect.