Bone graft addition
1. General considerations
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.
2. Harvest site
Corticocancellous bone can be harvested from:
- Distal radius, proximal and radial to Lister’s tubercle
- Iliac crest
- Proximal ulna
3. Harvesting
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.
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.
