Bone graft addition

Cancellous bone graft may be necessary for the following indications:

Fracture comminution, particularly with palmar cortical bone defect
Defect after removal of loose fragments
Delayed presentation with bone resorption

Cancellous bone can be harvested from either:

Distal radius, proximal and radial to Lister’s tubercle
Olecranon
Iliac crest

Note: If bone graft addition is planned, apply the draping of the arm above the elbow to have the option for harvesting off the olecranon if needed.

Location of harvest site near Lister’s tubercle for corticocancellous bone

Olecranon harvest site

Make a 2 cm longitudinal incision proximal to Lister’s tubercle. Retract the tendons of the second compartment radially and the extensor pollicis longus (EPL) in an ulnar direction.

Making a longitudinal incision proximal to Lister’s tubercle during harvest of bone for grafting

Use an osteotome chisel to cut three sides of a small square. Lift the dorsal radial cortex as a flap. After harvesting cancellous bone, replace the “lid” and close the wound.