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. 2025 Jul 25;20:702. doi: 10.1186/s13018-025-06058-7

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© The Author(s) 2025

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

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Fig. 4 — Case 1: A 32-year-old female suffered from post-traumatic nonunion and re-fracture developed humeral defect was managed by the technique of bone transportation combined with internal fixation. a The patient suffered from a severe distal humeral fracture caused by high-energy trauma; b open reduction and internal fixation surgery was performed 4 days after the accident; c, d it developed to a nonunion and implant failure 4 months after the initial surgery; e removing of the original internal fixation devices and the thorough debridement resulted in a 4.5 cm humeral defect, the patient underwent Surgical Technique 1; f. X-ray images at 2 months after the surgery show restoration of limb longitude without axial deviation or poor mineralization; g X-ray image at 7 months after the surgery, before the removal of the external fixator; h X-ray image at one year after removing the external fixator; i last follow-up examinations shows excellent functional recovery of the elbow