Bone graft addition

Corticocancellous 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 autograft or allograft may be considered.

$Insertion of bone graft in a comminuted articular fracture of the middle phalangeal base$

Corticocancellous bone can be harvested from:

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

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

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.