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Tibial Bone Grafting for Wrist Reconstruction
Schneider K Rancy1, Stephanie D Malliaris1, Scott W Wolfe1
1Department of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, New York.
Journal of Wrist Surgery
|April 22, 2017
Summary
Proximal tibia bone grafting offers a safer alternative to iliac crest harvesting for wrist reconstruction, with minimal complications and excellent patient outcomes. This technique reduces donor site morbidity for orthopedic procedures.
Area of Science:
- Orthopedic Surgery
- Bone Grafting Techniques
- Musculoskeletal Reconstruction
Background:
- Iliac crest bone graft harvesting is standard for orthopedic procedures but has high complication rates.
- Complications include nerve injury, hematoma, chronic pain, and fracture.
- A novel technique utilizes proximal tibia cancellous bone graft harvesting.
Purpose of the Study:
- To evaluate the safety and efficacy of proximal tibia bone graft harvesting.
- To compare outcomes with traditional iliac crest harvesting.
- To assess donor site morbidity and patient tolerance.
Main Methods:
- Retrospective review of 14 patients undergoing proximal tibia bone graft harvesting for wrist reconstruction.
- Data collected: tourniquet time, time to union, Visual Analog Scale (VAS) pain scores, complications.
- Postoperative phone questionnaires assessed patient experiences.
Main Results:
- Average donor site VAS pain score was 7.4 postoperatively.
- Average tourniquet time was 28 minutes.
- Average time to union was 45 days; one delayed union due to osteoporosis. No residual donor site issues reported at 24.2 months.
Conclusions:
- Proximal tibia bone graft harvesting demonstrates a minimal complication rate.
- Favorable clinical parameters and excellent patient tolerance support its use.
- Advocated as a preferred alternative to iliac crest harvesting for wrist reconstruction needing moderate autogenous cancellous graft.
