Autologous Wrapping Fibular Strut Graft and Iliac Bone Graft for the Treatment of Septic Non-union of Pediatric Ulnar Fracture: A Case Report.

Introduction: Infected non-union is rare in pediatric patients. Various methods have been described in the literature to manage such cases. We present a familiar and simple technique to treat a non-union in pediatric population. Case Presentation: A 4-year-old boy came to us with a right-sided proximal forearm swelling and tenderness. Clinical and radiological features suggestive of osteomyelitis of ulna with a history of the right-sided forearm cellulitis when he was 4 months of age which was managed with incision and drainage at that time. The patient underwent surgery for surgical debridement with drilling of ulnar cortex for pus evacuation. Postoperatively, the patient developed a stress fracture at drilling site which eventually went into a non-union. In second surgery, bony union achieved with the help of non-vascularized fibular strut graft and iliac cancellous graft. Conclusion: There are numerous complications of osteomyelitis in pediatric patients and their management has been previously highlighted throughout literature. Here, we present a rare occurrence case report highlighting management of pediatric atrophic infected gap non-union of ulna by non-vascularized fibula strut stabilized by Titanium Elastic nail which offers a simple yet an elegant solution in a low-cost setting with complete bony union and restoration of function.