Reconstruction of Severe Forearm Osteomyelitis

This article reviews the surgical management of severe chronic forearm osteomyelitis using free vascularized fibular flaps (VFFs), with or without the one-bone forearm (OBF) technique. Based on a 22 patient retrospective series, outcomes show that VFF enables reliable reconstruction of extensive bone and soft tissue defects following radical debridement. In selected cases, OBF offers a salvage solution for both radius and ulna bone loss. The approach led to high infection control rates, bone healing, and functional recovery. Microsurgical reconstruction, particularly using VFF, remains the gold standard for complex forearm infections, restoring structural stability and enabling meaningful upper limb function.