Reconstruction open radius and ulnar fractures

The images show repair of a right arm and hand injury in a male with a Gustilo grade 3B open radius and ulnar fractures sustained in a motorcycle collision (A, B, C). The distal fragment of the ulna was resected since it was outside of the wound, was not vascularized, and had little attachment of soft tissue. Definitive fixation was conducted with a plate (D), and the wound was closed by skin grafting (E).