USE OF BONE GRAFT FROM THE ELBOW

The most important principle of reconstructive surgery is; while completing the missing tissue from another part of the body, it should leave a negligible functional and/or visual deficiency in the area where it is taken.

The tissue part transfered from one part of our body to another is called "graft". In some cases, if the amount of transplanted tissue is large or very specific, it is transplanted together with the arteries and veins that keep it alive. These transferred tissues are called “flaps”.

Bone graft is frequently used in hand surgery practice. Major deficiencies that require the bone to be transplanted as a flap are seen rarely. The most preferred source of bone graft by most surgeons is the hip bone (crest of the iliac bone). For relatively small deficiencies, a bone graft can be obtained from the radius close to the wrist or from the elbow tip of the ulna, which we call the olecranon.

Bone removal from the elbow does not require additional anesthesia in patients who have undergone surgery with axillary anesthesia. After a 0.5-1 cm incision made on the back of the elbow, it is easily obtained with the help of a special device and fluoroscopy( that takes continuous X-rays).

Bone losses during trauma, non-union fractures and deficiencies after removal of benign bone masses are among the most common reasons for the use of bone grafts in hand surgery. In these cases, small deficiencies are encountered in which the graft taken from the elbow is sufficient. If the hip bone is to be used as a source for upper extremity problems, the patient will need to be put into sleep. However, since a significant part of hand surgery operations can be performed under axillary anesthesia (axillary block), if bone graft taken from the elbow is preferred, there will be no need for general anesthesia. In addition, walking difficulties and pain will not be felt which is the case for a few days after the bone is removed from the hip. Postoperatively donor side is less painful compared to people who have received a graft from the radius, and the scar is almost unnoticeable. For this reason, if the operation area and the area where bone can be taken from the radius are not performed with the same incision, the choice is usually the olecranon bone graft taken from the elbow.

As we have mentioned in many international medical publications, in our clinic, bone graft taken from the elbow (olecranon bone graft) is used quite frequently. Elderly individuals with extensive osteoporosis, patients with previous elbow trauma and/or surgery are carefully evaluated before surgery, and other graft sources are evaluated in inappropriate cases. Among the complications of olecranon bone graft are; swelling due to blood collection (hematoma) and tenderness in the grafted area are very rare, infection or fractures that may occur while grafting are much less common.