Harvesting olecranon bone graft in adults by using bone biopsy trephine

Fatih Kabakas, Meric Ugurlar, Abdulkadir Sari, Baris Caypinar, Berkan Mersa, Ismail Ozcelik
2016 Hand and Microsurgery  
Objectives: Bone grafts have been used for more than one hundred years in orthopedic surgery. Autografts are still the gold standard with respect to their osteoconductive, osteoinductive and osteogenetic peculiarities. Cancelleous grafts are the most commonly used autografts with their porous structure increasing the contact area. Although iliac crest is the preferred donor site, the femur, tibia, distal radius and olecranon are also employed when they are in a suitable location for the
more » ... ion for the recipient site. The olecranon donor site can provide ample amounts of bone graft for reconstruction in the upper extremity. Here, the bone graft harvesting from the olecranon with the use of trephine as a safe and fast technique is presented. The bone graft harvested with trephine not only has the proper morphology to be used for phalanx and metacarpal reconstruction, but also can be utilized for wrist and forearm procedures. Methods: 82 patients (21 female) had bone reconstruction with olecranon bone graft harvested with trephine between 2010 and 2015. The mean age was 34 (range: 20-62) years. The mean follow-up period was 26 (range: 6-48) months. Results: None of the patients had pain or decrease in the range of motion in the early or late postoperative period. Only one patient (1.2%) had hematoma formation at the donor site and no other complications were observed in any patient. There was no difference in elbow extension strength between both elbows at the postoperative fifteenth day and at the end of the follow-up period. Conclusion: Bone graft harvesting with trephine is technically easy and fast, and donor site morbidity is diminished compared other methods and donor sites. It can be performed under axillary anesthesia and provides adequate amounts of bone graft for upper extremity reconstructions. ABSTRACT Background: Distal fingertip amputations with exposed bone is challenging for the surgeon to manage. In order to reconstruct a good sensate pulp with appropriate closure, various flaps are advocated in the literature. Of these, palmar advancement flap, first described by Moberg in 1964, comprises one of the most popular options. Methods: Thirteen patients (11 male, 3 female) with fingertip injuries were operated. Following the elevation of Moberg flap, proposed modifications were carried out. Joint mobility and pulp sensitivity were recorded as well and advancement scores were noted before and after the modification. These scores were assessed statistically. Results: No complications were noted and there was no need for additional surgery. Excellent joint mobility and pulp sensitivity were maintained. This modification showed a statistically significant improvement in the advancement (p<0.05). Conclusions: Moberg flap is a good option for the closure of fingertip defects. Some simple modifications, as described in here, can enhance the advancement while securing the entire advantages of the flap. Year 2016 | Volume 5 | Issue 2 | 44-49 45 | Hand and Microsurgery Kabakas F et al.
doi:10.5455/handmicrosurg.214637 fatcat:cr25gexylzejrdvf3gnkbi5un4