Late results with local bone graft donor sites in hand surgery.

In 124 reconstructive hand procedures requiring bone grafts, the hand and forearm were used exclusively as a donor site for autologous cortical and cancellous bone. In 78 cases, the bone was obtained from the distal radius; in 19 it was obtained from the proximal ulna; and in the remaining 27 it was obtained from the metacarpals, carpals, and phalanges. The graft size composition, and the age of the patient determined the donor site. The bone grafts were ample in size to provide good structural support and osteogenic stimulation. After an average follow-up period of 22 months, there were no donor site complications. These findings establish that the local bone graft donor site provides sufficient bone and is clinically safe for use in most procedures in reconstructive hand surgery.