Harvesting olecranon bone graft in adults by using bone biopsy trephine
ABSTRACT
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 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.
Key words: Olecranon, bone graft, bone biopsy, trephine