Single-stage Operation Research Articles

Design of a Single-Stage Power Converter Operating in Burst and Continuous Modes for Low-Power Energy Sources

A single-stage power converter, operating in either the burst or continuous mode for low-power energy sources, is presented in this brief. With the proposed converter, the energy from the ambient energy source is processed once (i.e., a single-step conversion process) before powering the load circuits, thereby allowing an increase in the overall efficiency once compared to two-step conversion processes. The proposed power converter is designed using off-the-shelf components consisting of a boost converter, a temporary storage element (i.e., supercapacitor) and an output switching circuit (OSC). The OSC is used to manage the duration period for the load that operates in either the burst or continuous mode. The proposed power converter can start the operation from an input voltage as low as 0.3 V and up-convert the output to about 3.7 V. This brief achieves a peak end-to-end efficiency of 70.06% through a single-step power conversion. The proposed power converter can support an output power range from 1 $\mu \text{W}$ to 202 mW. Once compared to prior work, the proposed power converter can achieve a wide dynamic load range, a higher end-to-end efficiency with a low input voltage as well as a single-step power conversion.

Desmoid Type Fibromatosis of the Breast: Ten-Year Institutional Results of Imaging, Histopathology, and Surgery

Background: Desmoid type fibromatoses has proven to be a diagnostic and therapeutic challenge, as they often appear primarily as a carcinoma of the breast with a high recurrence risk. Patients: A digital archive search was performed for the period from 2009 to the end of 2018. Inclusion criteria consisted of histological examination of at least the surgical specimen in the reference pathology department and at least a second opinion diagnosis in the reference radiology department. Results: A total of 14 women and 1 man underwent surgery on desmoid type fibromatosisof the breast. The average patient age was 49 years (range: 22–72 years). The mean tumor size was 2.2 cm (range: 0.8–4.2 cm). The tumor was detectable in mammography in 12 out of 13 patients and in all 15 patients in sonography. MRI was performed preoperatively in 6 patients; in all of the patients, the tumor was visualized with inhomogeneous contrast enhancement. In the imaging procedures, all desmoid type fibromatoses were classified as suspicious. Performing the core biopsy, preoperative histology confirmed desmoid fibromatosis in 12 out of 15 patients. Nuclear stain for ß-catenin was positive in 7 out of 10 patients.Negative staining was found for AE1/A3 in 10 out of 10 and CD34 in 12 out of 12 patients. In all of the patients, a single-stage operation without the detection of border-forming tumor margins was performed. The follow-up interval ranged from 16 to 96 months (mean: 44.86 months, median: 43 months). In this follow-up period, no patient was diagnosed with desmoid tumor recurrence. Conclusion: In imaging, desmoid type fibromatosis of the breast has typical malignancy-related criteria. Extensive preoperative diagnostics enable the planning of complete primary excision of the lesion and reduce the recurrence risk.

Single-stage clipping with bifrontal and bilateral frontotemporal craniotomies for subarachnoid hemorrhage with multiple cerebral aneurysms using Sugita head holding system: A case report.

Background: Subarachnoid hemorrhage with multiple aneurysms is very challenging because it is difficult to identify the ruptured aneurysm. We could not identify the ruptured aneurysm preoperatively, so we decided to treat all of the aneurysms as a single-stage surgery.Case Description: A 79-year-old woman was diagnosed with subarachnoid hemorrhage with multiple cerebral aneurysms at the right distal anterior cerebral artery, left middle cerebral artery, and right internal carotid artery- posterior communicating artery bifurcation. We could not identify the ruptured aneurysm preoperatively. We fixed her head using the Sugita head holding system (Mizuho Co., Ltd., Tokyo) and performed clipping for each aneurysm with bifrontal craniotomy and bilateral frontotemporal craniotomy as a single-stage operation. The last aneurysm seemed ruptured, and clipping for all the aneurysms was successful. She was discharged with a good postoperative course. The Sugita head holding system allowed turning the head of the patient toward the right and left with single fixation, leading to this single-stage operation.Conclusion: Several methods for identifying a ruptured aneurysm from multiple aneurysms have been reported, but under limited medical resources, this procedure would be one of the treatment strategies.

Combined Torque Converter for Mining Machines

Transmissions of many technological and transport machines for mining enterprises are equipped with hydro-mechanical transmissions (HMT) with torque converters. HMTs have a number of positive properties. But a significant drawback of traditional automotive single-stage (single-turbine) torque converters is their relatively narrow torque ratio, which most often makes 2 or 3. Multi-stage torque converters in which two or three turbines are simultaneously connected to the output shaft demonstrate higher converting properties. The toque ratio of multi-stage hydraulic torque converters makes 4-6 or more. The drop in the efficiency in the range of large ratios and the lack of hydraulic coupling mode is one of the disadvantages of multistage torque converters. In order to overcome these shortcomings, the design of a combined torque converter is proposed. It combines modes of operation with one and two active turbines, as well as modes of hydraulic coupling and blocking. The main turbine of a combined torque converter is of the centrifugal type. The combination of single-stage and two-stage operation modes is achieved through the use of a composite pump wheel, one part of which can be used as a second centrifugal turbine. Two clutches are provided to control the torque converter.

Feasibility study of iron ore fines beneficiation by shallow bed air fluidized separator

Magnetic separation, dense media suspension fluidization techniques are tested for dry beneficiation of iron ore fines presently and found to have limitations. In the present study, the potential of shallow bed air fluidized separator (SBAFS), which does not have any suspension media and has high throughput is investigated for iron ore fines beneficiation. A set of experiments was designed by response surface methodology. Three parameters air flow rate, vibration frequency, and side tilt were considered for the experimentation. The individual effects of these factors and their interaction on yield and grade of concentrate products were studied. Experimental results show that grade of iron ore fines was enhanced by 5.5% in single stage operation with reasonable yield. Experimental results indicate that SBAFS has a huge potential for iron ore fines beneficiation with the added advantage of the reduction of water consumption during the beneficiation process. In order to understand the segregation of iron ore fines on SBAFS, mathematical equations were derived from the first principle of the force balance equation. Particle trajectories of different densities of mineral phases in iron ore fines were estimated by using the developed model. Simulation of particle trajectories was carried out by MATLAB software.

Single Sitting Bilateral Myringoplasty: Outcomes and Complications

Abstract Background Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations. Traditionally each ear drum is taken up for grafting sequentially in two different sittings. The reluctance to deal with both sides at the same sitting has been primarily due to a theoretical risk of iatrogenic sensory-neural hearing loss, need of bilateral ear canal gauze packing and chances of graft intake failure. Chronic Suppurative Otitis Media (CSOM) is a widely prevalent public health problem presenting with discomfort, hearing loss, otorrhea and psychological trauma. CSOM is characterized by an inflammatory process of the middle ear often associated with irreversible tissue alterations. It may be further classified into safe chronic otitis media and unsafe chronic otitis media according to the absence or presence of a cholesteatoma. Aim This study aim at assessing the single stage bilateral surgical procedure in bilateral tympanic membrane perforation caused by chronic otitis media as regard the graft take and hearing improvement as outcomes. Methodology A meta-analysis study is done to assess the feasibility and the possibility of operating the bilateral perforation in tympanic membrane in chronic otitis media cases on same session rather than doing it in separate sessions. The outcomes that were selected to evaluate such approach are graft take and hearing improvement. Hospital stay, cost of the operation and time were supposed to be evaluated however, there was no sufficient data to treat such outcomes in this meta analytic study upon that these outcomes are going to be appraised and stated bases on the available data. Results The graft take was evaluated on the bases paper by ototscopic examination post operative from 3 weeks to 3 months by closure of the perforation. It was estimated in this study to be 88%. This percent is matching the result obtained by Ihsan et al 2016 “who operated on 50 patients with a graft uptake rate of 86 %”, Olusesi et al, 2017 " with a total of 38 participants underwent either bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential different-day tympanoplasty (20 patients, 40 ears). The overall graft take rate was 88 per cent (32 out of 36 ears in the same-day tympanoplasty group, 35 out of 40 ears in the different-day tympanoplasty group; p = 0.96, odds ratio = 0.984)" (88 %), and Katsura et al, 2005 who revised the SUM using a 17 patients who underwent bilateral same-day surgery with a success rate of (85%). Conclusion Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation with a high success rate as regard the graft take and hearing improvement.

Six-Switch Step-Up Common-Grounded Five-Level Inverter With Switched-Capacitor Cell for Transformerless Grid-Tied PV Applications

Photovoltaic string inverters with transformerless grid-connected architecture are the most commonly used solar converters owing to their appliance-friendly and cost-effective benefits. A novel circuit configuration for these converters is presented in this article, which seeks to address the shortcomings of most of the conventional topologies such as the problem of leakage current, voltage ratio transformations, and power quality. The proposed structure is based on the series-parallel switching conversion of the switched-capacitor (SC) cell and is comprised of only six unidirectional power switches with a common-grounded (CG) feature. Through the use of the SC cell and the CG connection of active and passive used elements, not only is the number of output voltage level enhanced by up to five but also a two times voltage boosting feature with a single-stage operation as well as elimination of the leakage current is acquired. Herein, to inject a tightly controlled current into the grid, a peak current controller approach has been used which can handle both the active and reactive power supports modes. Theoretical analysis, design guidelines, comparative study, and some experimental results are also given to corroborate the feasibility and accurate performance of the proposed topology.

Cochlear Implantation in Patients with Chronic Suppurative Otitis Media: Surgical Outcomes and a Management Algorithm

Background: Chronic suppurative otitis media (CSOM) was considered as a contraindication of cochlear implantation (CI) in the past. Recently, various surgical options have been adopted for CI in CSOM patients with showing a low complication rate. Objectives: To evaluate surgical outcomes of CI in patients with CSOM and to propose a management algorithm for those patients. Methods: Thirty-six consecutive patients with CSOM who underwent single stage or staged CI were enrolled. Speech performance, including Categories of Auditory Performance (CAP) test and sentence score, and complications were retrospectively analyzed. Results: The average follow-up was 3.1 years (range 0.5–9.2 years). Postoperative median CAP and sentence scores were 6 and 78%, respectively. Three (8.3%) of the 36 patients had postoperative complications. One experienced breakdown of the ear canal closure. Recurrence of the pars tensa retraction was observed in another patient with adhesive otitis media who underwent CI and cartilage tympanoplasty as a single stage operation. Electrode extrusion occurred in another patient who underwent staged CI with maintenance of a previous open cavity. Subtotal petrosectomy and cavity obliteration were used to manage the latter 2 complications. All implant patients with good mastoid pneumatization exhibited no complications. There were no significant differences in postoperative speech performance and complication rates between single stage CI and staged CI. Based on these current findings, a management algorithm was proposed according to type of CSOM, presence of open cavity, and mastoid pneumatization. Conclusions: Patients with CSOM show good postoperative speech performance after CI. Proper surgical options according to type of CSOM, presence of open cavity, and mastoid pneumatization may help in reducing complications.

A Magnetically Controlled Single-Stage AC–DC Converter

In this letter, a magnetically controlled single-stage ac-dc converter is proposed for low-power application which has the following features. First, single-stage operation is achieved by sharing switches between LLC resonant converter and totem-pole bridgeless power factor corrector (PFC) converter. Second, the power factor correction function is inherently achieved by designing the PFC converter to operate in discontinuous conduction mode. Third, the dc-link voltage is almost constant. Fourth, fixed switching frequency and duty cycle can be implemented for the switches, which simplifies the magnetic component and driver circuit design. Fifth, the LLC resonant converter is designed to operate at series resonant frequency, the highest efficiency operating point, so the converter can always achieve the maximum efficiency operation. Meanwhile, at this operating point, the converter output voltage is independent of the load so that it is functioning as a dc transformer; and finally, soft switching for all semiconductors is achieved. A 75-W experimental prototype is built to validate the proposed magnetically controlled single-stage ac-dc converter.

Single‐phase common‐grounded transformer‐less grid‐tied inverter for PV application

In this study, a novel topology for the single-phase transformerless grid-connected inverters family is proposed. By using the series-parallel switching conversion of the integrated switched-capacitor module in a packed unit, several merits can be added to the proposed inverter, such as higher efficiency, boosting ability within a single-stage operation, and removing the leakage current problem by using the common grounding technique. In this study, a peak current controller strategy is implemented in order to generate the gate pulses of semiconductor switches. Moreover, this strategy is used to control both the active and reactive powers. Therefore, a thoroughly controlled current with a proper quality can be supplied to the grid from a single source renewable energy resource. The operating procedure, design consideration, comparison study, and the experimental results for a 510 W prototype are presented in order to validate the correctness and feasibility of the proposed topology.

The safety and efficacy of laparoscopic common bile duct exploration for the management of choledocholithiasis after endoscopic retrograde cholangiopancreatography failure: an observational study carried out in Al-Azhar University Hospital in Assiut

Background objective To assess the efficacy of laparoscopic common bile duct exploration (LCBDE) (in conjunction with laparoscopic cholecystectomy) as a single-stage operation to manage CBD stones failed to be extracted by endoscopic retrograde cholangiopancreatography (ERCP) and to evaluate the possible complications related to CBD stones. Patients and methods The study includes 30 patients diagnosed as having CBD stones proved clinically and through laboratory investigations in the form of obstructive jaundice and confirmed radiologically using hepatobiliary ultrasound and magnetic resonant cholangiopancreatography. All patients had a failed trial of ERCP stone extraction. They had a mean age of 51.067±11.32 years, and 40% of patients were males versus 60.0% were female. Results Postoperative follow-up was done after 1 week in the study group. Regarding postoperative ultrasound, 93.3% of patients had clear duct. Moreover, there was no pancreatitis in 96.7% of patients. Regarding cholangiogram, 93.3% had no stone. The mean hospital stay was 2.60 days, and 46.7% of the patients had a duration of staying at hospital of 2 days and 33.3% of patients had 3 days. Conclusion Laparoscopic bile duct exploration has achieved acceptance among the surgeons as a substitution to ERCP for management of CBD stones. Although its safety and successfulness are already confirmed among young patients in the elective setting, this study points to the rising proof of its safety among the elderly patients, in both elective and emergency settings. In centers that are capable of offering LCBDE to patients with CBD stones, LCBDE should be attempted in elderly patients observed to be fit for laparoscopic cholecystectomy.

Multistage pressure-retarded osmosis configurations: A unifying framework and thermodynamic analysis

Pressure-retarded osmosis has enjoyed increasing research interest over the last decade. Recent studies focusing on single-stage PRO designs have raised doubts regarding the long-term economic viability of the technology. While most of the analyses are based on single-stage operation, comprehensive analysis of multistage PRO which shows promise for better energetic performance is absent. Previous studies on multistage PRO differ in their design philosophies and performance metrics, leading to an incomplete assessment regarding the potential benefits of multistaging. In this paper, we develop a unifying framework to classify several existing multistage configurations. In addition, we analyze the multistage PRO system from a thermodynamic perspective. Among the two major multistage design strategies, namely interstage pressure control and independent feed inputs to each stage, we found the latter to be more effective towards increasing net power density. In comparison to a single-stage device, a 10-stage system achieves around 9% higher net power density while using the same membrane area.

The optimization of squeeze casting process parameter for AA2219 alloy by using the Taguchi method

The squeeze casting process have huge potential to produce excellent smooth surface finish profile and have a capability to produce near net product. The squeeze casting is a combination process of forming and forging with a single stage operation without porosity. An attempt is made to optimize the process variables of squeeze casting parameter such squeeze pressure load, die and melt temperature using the L9 orthogonal array with three different levels in order to determine the S/N ratio for density and hardness which is considered as response of the squeeze casting operation. Taguchi analysis performed on the response of squeeze casting in order to determine the most significant process parameter effecting on hardness and density. The Regression equation was devolved to perform a confirmatory test. The Squeeze casting process parameter optimized for AA2219 alloy at squeeze pressure 650 MPa, die pre heating temperature 225°c and melt temperature 700°C which produced better mechanical response and metallography structure. The microstructure of squeeze casted sample was analysed along the radial direction with help of an optical microscope. Microstructure evaluation conforms the presence of fine grains which can be obtained only at the optimized process parameter.

A New Single-Phase Transformerless Grid-Connected Inverter With Boosting Ability and Common Ground Feature

A new scheme of single-phase transformerless grid-connected inverter is presented in this article. By employing the series-parallel switching conversion of the integrated switched-capacitor module in a packed unit, some attractive features for the proposed inverter can be obtained. Such promising features can be quantified as more than 97% overall efficiency for a wide range of output power, two-time boosting ability within a single-stage operation and almost total suppression of the leakage current through using the common grounding technique. In this case, a peak current controller strategy is used in order to trigger the gate of power switches and control both the active and reactive powers. Therefore, a tightly controlled current with an appropriate quality can be injected to the grid from a single source renewable energy resource. Operating procedure, design consideration, comparison study, and a 513 W built prototype results are also given to prove the correctness and feasibility of the proposed circuit.

A Fuzzy Controlled SEPIC-ZETA Converter with Single Stage Operation for Application in Electric Vehicle

In this paper a SEPIC-ZETA power factor correction converter is introduced with fuzzy control for better performance. The controller of the converter is updated with 49 rule base fuzzy interface system with 7 membership functions in each input variable. The novel proposed converter operating modes are observed with change in switching states. For application a three-phase induction machine with inverter is connected to the proposed circuit. The characteristics of the converter and the machine are studied using MATLAB Simulink environment.

A New Transformer-Less Five-Level Grid-Tied Inverter for Photovoltaic Applications

A new fundamental structure of a single-phase transformer-less grid connected multilevel inverter based on a switched-capacitor structure is presented in this study. By employing the series-parallel switching conversion of the integrated switched-capacitor module in a packed unit, attractive features for the proposed inverter can be obtained such as high efficiency and boosting ability within a single stage operation. Also, using a common grounding technique provides an additional advantage of reducing the leakage current. Moreover, the presented structure generates a multilevel waveform at the output voltage terminals which reduces the harmonics in the system. A peak current controller is utilized for triggering the gate of the power switches and controlling both the active and reactive powers. This results in a tightly controlled current with an appropriate quality that can be injected to the grid using a single source renewable energy resource. Operating procedures, design considerations, comparison studies and test results of a 620 W prototype are also presented to validate the accuracy and feasibility of the proposed multilevel inverter.

Oncoplastic Central Partial Mastectomy and Neoareolar Reduction Mammoplasty with Immediate Nipple Reconstruction: An Initial Report of a Novel Option for Breast Conservation in Patients with Subareolar Tumors.

Breast-conserving therapy (BCT) has been associated with better quality of life and cosmetic outcomes than mastectomy. However, subareolar cancers abutting the nipple-areolar complex (NAC) present a unique cosmetic and oncologic challenge. Oncoplastic central partial mastectomy and neoareolar reduction mammoplasty with immediate nipple reconstruction is a novel technique that can permit BCT for these patients. This study enrolled consecutive patients with central tumors during 2017-2018 who underwent central partial mastectomy reconstructed with neoareolar reduction mammoplasty and immediate nipple reconstruction. Patient demographics, imaging and pathology size, margin width, mastectomy and reexcision rates, and cosmesis were evaluated. The study identified 23 sequential patients. The average patient age was 60.5 ± 12.3years, and the average body mass index was 29.4 ± 5.7kg/m2. The mean lesion size was 51.5 ± 43.0mm on preoperative imaging, and the average disease span shown by the final pathology was 59.5 ± 45.3mm. "No ink on tumor" was achieved for 22 patients (95.7%). In 13 patients (56.5%), the margins were inadequate for ductal carcinoma in situ (DCIS) (n = 12) or invasive cancer (n = 1). Good to excellent cosmetic results were achieved for 21 patients (95.5%). Complications occurred for six patients (26.1%), including three patients with ischemia of the reconstructed NAC. The single-stage operation described in this report can allow patients with cancers abutting the NAC to consider BCT. This technique allows patients to avoid mastectomy and to minimize the number of operations required for reconstruction while maximizing cosmetic outcomes. In the study cohort, the presence of extensive DCIS resulted in a significant need for reexcision, which could be performed successfully without compromise to cosmetic outcome.

Optimal surgical approaches and treatment outcomes in patients with jugular foramen schwannomas: a single institution series of 31 cases and a literature review.

Complete resection of jugular foramen schwannomas (JFSs) with minimal cranial nerve complications remains difficult even for skilled neurosurgeons. Between November 2011 and November 2017, 31 consecutive patients diagnosed with JFSs underwent a single-stage operation performed by the same neurosurgeon. We retrospectively analyzed clinical characteristics, surgical approaches, treatment outcomes, and follow-up data for these patients. JFSs were classified according to the Samii classification system. A retrosigmoid approach was used to resect type A tumors, while a suboccipital transjugular process (STJP) approach was used to resect type B tumors. Notably, the present study is the first to report the use of a paracondylar-lateral cervical (PCLC) approach for the treatment of type C and D tumors. Type A-D tumors were observed in seven, four, four, and 16 patients, respectively. Gross-total resection was achieved in 29 patients (93.5%). There were no cases of intracranial hematoma, re-operation, tracheotomy, or death. Adjunctive gamma knife treatment was used to manage residual tumors in two patients. Neurological deficits relieved in half of patients at the last follow-up. By reviewing the studies published on PubMed, the approaches gradually be more conservative, rather than widely expose the skull base. Nonetheless, endoscope and stereotactic radiosurgery plays an important role in the management of JFSs. Both tumor removal and neurological function retention can be obtained by choosing individual treatment.

P107. Releasing anterior soft tissue and reduction of the irreducible atlantoaxial dislocation associated with basilar invagination through single-stage posterior approach

BACKGROUND CONTEXT The management of AAD combined with BI is challenging. Traditional posterior approaches lack the ability to release the anterior soft tissue and result in unsatisfactory reduction; posterior fixation followed by the anterior release approach has higher morbidity and lead to higher costs and a longer length of stay. PURPOSE This study aims to analyze outcomes of the release of anterior soft tissue through posterior route in order to reduce irreducible atlantoaxial dislocation (AAD) and basilar invagination (BI) through a single-stage operation. This study aims to analyze outcomes of the release of anterior soft tissue through posterior route in order to reduce irreducible atlantoaxial dislocation (AAD) and basilar invagination (BI) through a single-stage operation. STUDY DESIGN/SETTING This is a retrospective study. PATIENT SAMPLE Thirty-one patients with irreducible AAD and concomitant BI with congenital osseous abnormalities were analyzed. OUTCOME MEASURES The clinical results were evaluated using the Japanese Orthopedic Association (JOA) scale, and the radiological measurements included anterior atlantodental interval (ADI), the distance of odontoid tip above Chamberlain line, clivus-canal angle (CCA) and the length of the syrinx. METHODS The anterior soft tissue was released posteriorly, and cages were placed into the facet joint followed by occipital-cervical fixation with cantilever correction. We used paired t-test to compare preoperative and postoperative measurements. RESULTS The mean JOA score increased from 11.65 to 14.48 at 1-year follow-up. Complete reduction of AAD and BI was achieved in 23 patients (74.2%). The mean clivus-canal angle improved from 113.0 degrees preoperatively to 148.4 degrees postoperatively. Shrinkage of the syrinx was observed in 6 patients in one week after surgery. Nine patients had 18-month follow-up and achieved bone fusion. Twenty-two patients have a 12-month follow-up, and 19 (86.3%) achieved bony fusion. Unilateral vertebral artery occlusion was diagnosed in 2 cases without clinical symptoms. CONCLUSIONS It appears effective and safe to treat irreducible AAD associated with BI by releasing the anterior soft tissue from a posterior approach. Cage implantation within the facet and fixation using cantilever can achieve complete reduction in most cases. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Reconstruction of traumatic tubular bone defects using vascularized fibular graft

Large segmental bone defects due to major trauma constitute a major challenge for the orthopaedic surgeon, especially when combined with poor or lost soft tissue envelope. Vascularized fibular transfer is considered as the gold standard for the reconstruction of such defects of the extremities due to its predictable vascular pedicle, long cylindrical shape, and tendency to hypertrophy, and resistance to infection. Vascularized bone grafts remain viable throughout the healing period and are capable of inducing rapid graft union without prolonged creeping substitution, osteogenesis and hypertrophy at the reconstruction site, and fight with infection.The fibular graft can be transferred solely, or as a composite flap including muscle, subcutaneous tissue, skin and even a nerve segment in order to reconstruct both bone and soft tissue components of the injury at single stage operation. Such a reconstruction can even be performed in the presence of local infection, since vascularized bone and adjacent soft tissue components enhances the blood flow at the traumatized zone, allowing for the delivery of antibiotics and immune components to the infection site.In an effort to preserve growth potential in pediatric patients; the fibular head and proximal growth plate can be included to the graft. This practice also enables to reconstruct the articular ends of various bones, including distal radius and proximal ulna. Apart from defect reconstruction, vascularized fibular grafts also proved to be a reliable in treating atrophic nonunions, reconstruction of osteomyelitic bone segments. These grafts are superior to alternative reconstructive techniques, as bone grafts with intrinsic blood supply lead to higher success rates in reconstruction and accelerate the repair process at the injury site in cases where blood supply to the injury zone is defective, poor soft tissue envelope, and local infection at the trauma zone.