To the Editor:
The olecranon is a useful donor site for bone grafts upper extremity surgery because of its minimal nor site morbidity, proximity to the recipient site, se of adjusting volume and shape, and adequacy of e cancellous bone.1,2 For this purpose, we used a T-shaped bone biopsy phine to harvest corticocancellous or cancellous bone graft from the olecranon successfully in 16 patients with complicated hand and wrist fractures (Fig. 1).
Mean patient age was 27 years (range, 22–36 y). We make a small skin incision over olec- ranon and then incise and elevate the periosteum. We insert the trephine along the axis of ulna and rotate it to obtain the desired graft length. The trephine is then extracted by rotating in the same direction. The graft is gently pushed wire out of the trephine with a Kirschner wire. Mean operation time from skin inci- sion to closure was 5 minutes (range, 3–7 min). No postoperative elbow immobilization was needed. Patients started resting on the elbow after 10 days.
There were no pathologic fractures, contour deformities, or sensory or motor deficits. Fujita et al3 used a skin trephine to harvest iliac crest bone in children, but this fragile trephine would not likely work in compact adult bone. Burstein et al4 also compared the use of special bone trephines with the other graft-harvesting techniques in children. They noted that the trephine technique had less morbidity than conventional harvesting techniques while pro- viding adequate bone for alveolar bone grafting. Wedecreased operation time, postoperative pain, and scar length without disturbing elbow movement or
sensation. Our patients were young and had good bone stock. Bone density could be assessed in older patients to help assess the risk for pathologic fractures.