Re: Ozcelik B, Kabakas F, Mersa B. Treatment of nonunion of the distal phalanx with olecranon bone graft. J Hand Surg Eur. 2009, 34: 638-42

Comparing Morbidities of Bone Graft Harvesting from the Olecranon Process and the Distal Radius

The aim of this study is to compare donor-site morbidities between patients who underwent bone graft harvesting from either the olecranon process (OP) or the distal radius (DR).

METHODS

We evaluated 44 patients who underwent bone graft harvesting from the OP (25 cases) or the DR (19 cases) for various procedures in the ipsilateral upper extremity. Follow-up averaged 14 (OP group) and 19 months (DR group). Outcome measures included visual analog scales (VAS) for graft harvest-site pain and scar appearance, joint motion, and x-rays of the graft harvest and recipient sites. The VAS scores ranged from 0 to 10 with a low score reflecting no pain and excellent satisfaction and a high score reflecting severe pain and poor satisfaction.

RESULTS

The VAS scores for pain averaged 0.4 (OP) and 0.5 (DR), and the VAS scores for scar appearance averaged 0.3 (OP) and 0.7 (DR). These differences were not significant. Within each group, there were no significant differences between the operative and nonoperative limbs for elbow or wrist motion. Early graft harvest-site complications involved 1 superficial wound infection (OP) and 1 wound dehiscence (DR). A graft harvest-site defect was detected by x-ray in 84% of OP cases and in 67% of DR cases. Bone healing at the graft recipient sites was observed in more than 87% of cases in both groups.

CONCLUSIONS

Bone graft harvesting from either the OP or the DR led to comparable patient- and evaluator-determined outcomes with low risks of complications. Surgeons can safely use either option.