Vol. 7, Issue 2, Part C (2025)

A 40-year-old male presented to the emergency department following a high-velocity roadside accident. He sustained multiple injuries, including an open wound over the left thigh and a comminuted fracture of the right femoral shaft with significant segmental bone loss. Additionally, there was an associated injury to the right forearm with midshaft fractures of both the radius and ulna. Initial management involved a staged surgical approach. In the first stage, thorough wound debridement, intramedullary nailing of the femur, and application of controlled distraction were performed to stabilize the limb and preserve length. After a two-month interval, definitive reconstruction was undertaken using a large non-vascularized free fibular graft, combined with autologous cancellous graft harvested from the right iliac crest and cadaveric allograft to bridge the femoral defect. At six months postoperatively, radiographic evaluation confirmed solid bony union with good graft incorporation and no evidence of limb length discrepancy. The patient achieved satisfactory functional recovery. This case demonstrates that, in selected post-traumatic scenarios with major femoral bone loss, a non-vascularized fibular graft augmented with auto graft and allograft can serve as an effective and biologically favourable reconstruction strategy.