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Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
Nonvascularized Iliac Crest Autograft for Wrist and Hand Reconstructions: A Report of Two Clinical Cases and
Joana Páscoa Pinheiro1, André Spranger1, Paulo Almeida1
1Department of Orthopedics and Trauma, Centro Hospitalar e Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal.
Introduction:
Bone defects of the hand and wrist may result from trauma or tumor resection and represent a reconstructive challenge due to the complex anatomy and functional demands of this region. Autologous bone grafting is commonly used to restore bone stock and preserve hand and wrist function.
Case Report:
Two patients with distal radius and carpal bone defects were treated using non-vascularized iliac crest autograft. Patient 1 sustained a high-energy motorcycle accident resulting in an open distal radius fracture with significant metaphyseal bone loss, managed with definitive osteosynthesis and iliac crest autografting. Patient 2 presented with a locally aggressive midcarpal bone tumor; following wide resection, the defect was reconstructed through carpal arthrodesis using the same autograft. At final follow-up, both patients were pain free and able to perform full activities of daily living.
Conclusion:
In selected cases, non-vascularized iliac crest autograft allows effective reconstruction of hand and wrist bone defects, providing stable bone healing, pain relief, and satisfactory functional outcomes.
