Bone graft addition

Cancellous bone graft may be necessary for the following indications:

• Fracture comminution, particularly with palmar cortical bone defect
• Defect after removal of loose fragments
• Delayed presentation with bone resorption

Cancellous bone can be harvested from either:

• Distal radius, proximal and radial to Lister’s tubercle
• Iliac crest

Make a 2 cm longitudinal incision proximal to Lister’s tubercle. Retract the tendons of the second compartment radially and the extensor pollicis longus (EPL) in an ulnar direction.

Use an osteotome chisel to cut three sides of a small square. Lift the dorsal radial cortex as a flap. After harvesting cancellous bone, replace the “lid” and close the wound.