Limb Salvage in a War Zone: Reconstruction of Extensive Radial Bone Loss Using a Nonvascularized Fibular Graft and...

High-energy blast injuries frequently result in complex bone and soft-tissue defects that pose significant reconstructive challenges, particularly in conflict zones where access to specialized surgical care is limited. Delayed treatment, infection, and soft-tissue compromise further complicate management and may lead to severe functional impairment. Segmental radial bone loss associated with extensive soft-tissue injury is especially difficult to reconstruct, often requiring staged procedures to achieve limb salvage and functional restoration. We report the case of a 17-year-old female who sustained a blast injury to her left forearm in Gaza, resulting in extensive soft-tissue destruction, segmental radial bone loss, and subsequent infection. Initial management was constrained by the collapse of local health care services during the conflict, necessitating evacuation from northern to southern Gaza to access specialized reconstructive care. Following serial debridement and successful infection control, reconstruction was performed using a nonvascularized fibular graft to address the radial defect, combined with a groin flap for soft-tissue coverage. The patient underwent staged surgical management, achieving successful graft incorporation, complete wound healing, restoration of limb stability, and satisfactory functional recovery.