Related Experiment Video
Updated: Jun 4, 2025
Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
[Cancellous bone harvesting from the distal radius for reconstruction of bone defects in the hand]
B Hohendorff1, B D Sannwaldt2, S Spät2
1Abteilung für Handchirurgie, Elbe Klinikum Stade, Bremervörder Str. 111, 21682, Stade, Deutschland. bernd.hohendorff@hotmail.com.
Objective:
Extraction of cancellous bone from the distal radius for reconstructive procedures on the hand.
Indications:
All reconstructive procedures on the hand for which a corticocancellous and/or vascularized bone graft or a large amount of cancellous bone is not required.
Contraindications:
Acute distal radius fracture, osteosynthesis material embedded in the distal radius, e.g., after palmar plate osteosynthesis of a distal radius fracture, tumor in the distal radius.
Surgical Technique:
Removal of cancellous bone from the distal radius radially from the dorsal radial tuberosity via a small bone window at the base of the second extensor tendon compartment.
Postoperative Management:
Wound dressing on the distal radius, elevation of the arm above heart level until swelling has subsided, first dressing change on postoperative day 1 or 2, depending on the primary procedure on the hand, dressing until wound healing is complete, removal of the skin sutures around postoperative day 14.
Results:
In 2023, cancellous bone was harvested from the distal radius of 17 patients for reconstructive procedures on the hand (6 mediocarpal partial arthrodeses, 3 acute fractures, 5 delayed bone healings, 1 pseudarthrosis, 2 bone tumors). In all cases, the available amount of radius cancellous bone was sufficient, resulting in satisfactory healing. All patients complained of short-term, slight discomfort at the donor site for the first few days after surgery, which resolved completely. There were no complications at the donor site on the distal radius.
