title: Tricortical bone graft for primary reconstruction of comminuted distal humerus fractures.
abstract: A tricortical bone graft harvested from the ilium was used to reconstruct a severely comminuted open intra-articular distal humerus fracture in an adult patient. The patient demonstrated a satisfactory functional and radiologic outcome despite loss of the lateral trochlear lip. When the lateral portion of the fractured trochlea cannot be repaired, excision of the fragments and insertion of an autogenous corticocancellous bone graft from the iliac crest can restore satisfactory function, even in the setting of an open fracture provided there is limited contamination and tissue devitalization. Radiocapitellar contact may be essential to good elbow function in this situation, because the corticocancellous bone graft does not restore the important lateral lip of the trochlea.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, St. James's University Hospital, Beckett Street, Leeds, United Kingdom. pgiannoudi@aol.com
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
authors.forename: M K
authors.initials: MK
authors.lastname: Al-Lami
authors.forename: C
authors.initials: C
authors.lastname: Tzioupis
authors.forename: D
authors.initials: D
authors.lastname: Zavras
authors.forename: M R W
authors.initials: MR
authors.lastname: Grotz
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D005597:Fractures, Open / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D007082:Ileum / Q000637:transplantation*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome