Spongiosaentnahme aus dem distalen Radius zur Rekonstruktion von Knochendefekten an der Hand

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.