Minimally Invasive Reconstruction of Traumatic Segmental Femoral Bone Loss Using a Non-Vascularised Ipsilateral Fibular Graft in a Three-Year-Old Child: A Case Report.

Traumatic segmental bone loss of the femur in very young children is exceedingly rare and presents significant reconstructive challenges. Although several reconstructive options, including distraction osteogenesis, vascularised bone grafting, and the induced membrane technique, have been described, each carries inherent limitations, particularly in the paediatric population. We report the case of a three-year-old child who sustained traumatic extrusion of a segment of the femoral shaft following a motor vehicle accident. Reconstruction was performed using a minimally invasive technique with a non-vascularised ipsilateral fibular autograft stabilised with K-wires and a Limb Reconstruction System (LRS) external fixator. The patient demonstrated progressive clinical and radiological recovery with complete remodelling of the femur and regeneration at the fibular donor site. At final follow-up, the child had achieved painless full weight-bearing without deformity or limb length discrepancy. This case highlights the remarkable remodelling potential of bone in early childhood and suggests that minimally invasive reconstruction using a non-vascularised fibular graft may serve as an effective limb-salvage option in carefully selected paediatric patients while avoiding more complex staged reconstructive procedures.