A Case of Chronic Ulna Osteomyelitis in Paediatric Patient Managed with Fibula Grafting

Background: Chronic osteomyelitis in the paediatric population poses a significant therapeutic challenge due to persistent infection, bone loss, and the risk of functional impairment. Management requires meticulous surgical planning to eradicate infection while restoring skeletal integrity and limb function.

Case Presentation: An eight-year-old male child presented with chronic discharging sinuses over the ulnar aspect of the forearm following a history of trauma and multiple previous debridement procedures. Radiological evaluation revealed chronic osteomyelitis of the ulna with sequestration and segmental bone loss.

Management: The patient underwent staged surgical management, including sequestrectomy and complete resection of infected bone, followed by placement of antibiotic cement and temporary stabilization with a Kirschner wire. Due to failure of previous interventions and significant bone defect, definitive reconstruction was performed using autologous fibular bone grafting with square nail fixation.

Results: At 14 months of follow-up, the patient demonstrated good clinical and radiological recovery with satisfactory incorporation of the graft. Functional assessment showed a reasonable range of motion at the elbow joint, and the patient was able to perform routine daily activities such as writing and eating without difficulty.

Conclusion: Fibular bone grafting following thorough debridement is an effective and reliable option for managing chronic ulna osteomyelitis in paediatric patients, providing infection control, bone continuity restoration, and acceptable functional outcomes.