Spontaneous Bone Regeneration in an Open Segmental Fracture of the Forearm with Extruded Middle Segment

Open segmental fractures of both bones of the forearm with the loss of the middle segment of the radius is a rare injury in children. An eight-year-old boy presented to our clinic four days following a road traffic accident. The child's mother was carrying a 12-cm long extruded and soiled segment of the radius bone. The extruded bone segment seemed necrotic, and we decided not to use it for replantation. The wound over the forearm fracture was infected. It was debrided and regularly dressed until it became healthy. We planned to use a fibular graft for the gap and to fix the graft with a Kirschner wire (K-wire). The operation was delayed due to the poor wound condition. At the four-week follow-up, we noticed unexpected signs of bone regeneration in the bone defect of the radius. After eight weeks, a complete spontaneous reconstruction of the bone was noted. This case highlights the excellent healing potential of the bones in children, where even if a long segment of the bone is lost, we can expect spontaneous complete regeneration of the bone if the periosteum is intact and continuous.