{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:58:41Z","timestamp":1790585921125,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder that causes skeletal dysplasia and congenital pseudoarthrosis of the forearm, which is very difficult to repair. The vascularized free fibular flap (FFF) is the standard treatment. CAD\u2010CAM technologies and virtual surgical planning (VSP) offer greater precision and their full integration into primary pediatric reconstruction for NF1 is described. The objective of this case report is to present the simultaneous integration of all these tools in the primary reconstruction of a child with forearm pseudarthrosis due to NF1. We present the case of a 7\u2010year\u2010old boy with NF1 and radial pseudoarthrosis reconstructed using FFF, patient\u2010specific CAD\u2010CAM guides, and an interactive 3D VSP environment. A 3\u2010cm defect was reconstructed using an FFF and a premolded LCP plate. Bone union was achieved at 7\u20138\u2009months, with full range of motion in the wrist and nearly complete pronation\u2010supination. No morbidity was reported in the donor site. This case reports the complete integration of FFF, CAD\u2010CAM, and VSP in the primary reconstruction of a forearm pseudarthrosis in a child with NF1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>V Expert Opinion\/Case Report.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70285","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:31:21Z","timestamp":1787837481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radial Reconstruction With Fibular Free Flap Using\n                    <scp>CAD<\/scp>\n                    \u2010\n                    <scp>CAM<\/scp>\n                    and Virtual Surgical Planning in Pediatric Pseudoarthrosis due to Neurofibromatosis Type 1: A Case Report and Literature Review"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3031-2481","authenticated-orcid":false,"given":"Alicia","family":"Dean","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Rom\u00e1n","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Traumatology Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concepci\u00f3n","family":"Centella Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8695-9784","authenticated-orcid":false,"given":"Guillermo","family":"Rodr\u00edguez Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Traumatology Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genoveva","family":"Molina P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Alamillos Granados","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20067"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhsu.1999.0604"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558944716688531"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bpo.0000186241.29415.df"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BTH.0b013e318295238b"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2009.11.022"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","unstructured":"Bosch de Basea M. I.Thierry\u2010Chef R.Harbron et\u00a0al.2023. \u201cRisk of Hematological Malignancies From CT Radiation Exposure in Children Adolescents and Young Adults.\u201d29 no.12:3111\u20133119Erratum in: Nat Med 2025;31(7):2452.","DOI":"10.1038\/s41591-023-02620-0"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.07.021"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(94)90176-7"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558944717702472"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31817f025c"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2018.04.002"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12154981"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000001059"},{"key":"e_1_2_11_16_1","first-page":"332","article-title":"Congenital Pseudoarthrosis of the Radius With Neurofibromatosis Type 1: Report of Two Cases","volume":"21","author":"Jayakrishnan R.","year":"2020","journal-title":"Journal of Orthopaedics"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2024.06.015"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200409000-00010"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(93)90042-E"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.1920140408"},{"issue":"1","key":"e_1_2_11_21_1","first-page":"e33063","article-title":"Traumatic Radius Pseudoarthrosis in Neurofibromatosis Type 1: A Case Report","volume":"15","author":"Pamuk M. 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