Determination of the Optimal Location for Bone Graft Harvest in the Distal Radius.

BACKGROUND: The distal radius is commonly used as a bone graft donor site for surgery in the hand and wrist. The aim of this study was to evaluate the volume and relative density of cancellous bone in the distal radius.

METHODS: Thirty-four consecutive computed tomographic scans of the wrist in 33 patients without distal radius pathology were included. For each subject, 6 spherical regions of interest (ROIs) were identified within the distal radius. In each ROI, volumetric measurements and mean Hounsfield unit (HFU) values were recorded by 2 observers using a 3-dimensional imaging reconstruction software.

RESULTS: Compared with proximal bone, distal bone had larger volume (0.82 vs 0.27 cm3 ) and greater relative density (178 vs 152 HFU) on average. Among the 6 ROIs, the distal-central region had the largest average volume (1.20 cm3 ) and the distal-ulnar ROI had the greatest average relative density (193 HFU).

CONCLUSION: Based on these results, we recommend performing cancellous autograft harvest relatively distal and ulnar within the distal radius.