Divya Ravikumar has completed her MBBS degree from Azerbaijan Medical University. She is currently completing her internship at Medeor Hospital (Burjeel Holdings) Abudhabi. Demonstrating a early commitment to clinical excellence and academic scholarship, she has authored and peer-reviewed research spanning pediatric surgery, orthopedics, cardiology, and perioperative sustainability, including work published in the Cureus Journal of Medical Science. Her professional work bridges patient-centered clinical care, evidence-based research, and sustainable practices in surgical healthcare.

Staged Biological Reconstruction of Bayne Type III Radial Longitudinal Deficiency Using Gradual Ilizarov Distraction and Autologous Iliac Crest Bone Grafting: A Case Report and Review of Current Surgical Strategies   Background: Congenital radial longitudinal deficiency (RLD) is a rare upper-extremity developmental anomaly characterized by partial or complete absence of the radius, forearm shortening, radial wrist deviation, and soft-tissue contracture. Bayne Type III RLD involves partial radial aplasia with a preserved proximal radial remnant. Acute single-stage correction is frequently complicated by neurovascular tension, wrist stiffness, and high recurrence rates. Gradual distraction histogenesis followed by delayed skeletal reconstruction offers a staged biological approach to progressively elongate contracted soft tissues and restore forearm alignment. Case Presentation: A four-year-old boy (weight: 20 kg, height: 98 cm) presented with severe right-sided Bayne Type III RLD. Clinical evaluation revealed pronounced radial wrist deviation, forearm shortening, restricted active pronation and supination, and reduced upper-extremity muscle strength (Medical Research Council [MRC] grade 4/5). Plain radiographs and computed tomography (CT) confirmed partial absence of the radius with a preserved proximal radial fragment and ulnar bowing. Surgical Technique: Reconstructive management was executed in two stages. Stage I involved osteotomy of the proximal radial remnant and application of an Ilizarov circular external fixator for gradual distraction osteogenesis. Distraction was maintained over three months, achieving progressive soft-tissue elongation, alignment correction, and reduction of the osseous defect without neurovascular compromise. Stage II comprised frame removal, debridement of the residual gap, reconstruction using an autologous corticocancellous iliac crest bone graft, internal stabilization with Kirschner wires, and cast immobilization. Results: Postoperative follow-up demonstrated complete graft incorporation, full osseous union, and anatomical restoration of forearm alignment. Forearm pronation, supination, and wrist motion were fully restored, and muscle strength improved to MRC grade 5/5. No pin-tract infection, neurovascular injury, wire displacement, or recurrent radial deviation occurred, allowing the patient to return to age-appropriate daily activities without pain or functional restriction. Conclusion: Staged biological reconstruction utilizing gradual Ilizarov distraction followed by delayed autologous iliac crest bone grafting is an effective and safe treatment strategy for Bayne Type III RLD. Preserving the native proximal radial remnant while systematically mitigating soft-tissue tension minimizes surgical complications and achieves reliable skeletal union, anatomical alignment, and complete functional recovery. Keywords: Radial longitudinal deficiency; Bayne Type III; Ilizarov distraction osteogenesis; autologous iliac crest bone graft; pediatric orthopedics; upper-limb reconstruction.