Vascularized proximal fibular autograft is reported as one of the reconstructive procedures for the wrists following tumor resection in the distal end of the radius. However, it is rarely performed for the treatment of segmental bony defects in the distal radius after trauma. A 19-year-old man who had traumatic bony defects in the distal radius involving the articular surface underwent vascularized proximal fibular grafting for reconstruction of the wrist. After surgery, he regained wrist functions, with 40 degrees of flexion, 45 degrees of extension, 90 degrees of pronation, and 45 degrees of supination. No evidence of instability or degenerative changes was noted in the reconstructed wrist at 3 years after surgery. Vascularized proximal fibular autograft appears a useful procedure both for reconstruction of the wrist in cases with segmental bony defects in the distal radius after trauma, as well as for after tumor resection.