Using Free Double Barrel Vascularized Fibular Grafting in Complex Nonunion with extensive bone loss in distal humeral fractures

Distal humeral fractures are not very common. 3% of these fractures may need further surgical management [22]. Nonunion of fractures of the distal humerus is a challenging issue for orthopedic surgeons. Management could be either by using non vascularized or vascularized bone grafts, or by using a double barrel vascularized graft from the fibula. In our study we used a double barrel vascularized fibular graft for treatment this kind of nonunion. We used this procedure with different ways of fixation (either using external fixation, k wires with screws, plates) in different patients. Double barrel vascularized fibular grafting is a good option for treatment of fracture nonunion with a gap of 6 cm or more. It adds stability to the medial and lateral columns and enhances bone healing at the fracture site. Keywords: Double Barrel; Vascularized Fibular Graft; Non Union Humerus Fracture