title: Bone graft harvest from the proximal tibia in foot and ankle arthrodesis surgery.
abstract: BACKGROUND
  Fresh autogenous cancellous bone graft is the material of choice in reconstruction and fusion procedures in foot and ankle surgery. There are many potential donor sites for graft harvest, all with recognized minor and major complications. The proximal tibia is one such potential site and is particularly suited to foot and ankle surgery, because it is within the operative field and under tourniquet control.
  
  
  METHODS
  A retrospective review was performed of 148 procedures using bone graft from the proximal tibia performed over a period of 5 years. Minimum followup was 3 months. Data were obtained from operative notes and patient interviews to establish pain, morbidity, and overall satisfaction.
  
  
  RESULTS
  Most patients had no pain (78%) or very mild pain (20%) at the site of graft harvest immediately after surgery. At followup, 96% had no pain and 4% had very mild pain with certain activities such as kneeling. There were no major complications. Four patients (2.7%) had persisting areas of paresthesia at followup, but none were troubled by it. One patient had a superficial wound infection that resolved. The period of nonweightbearing, usually 2 to 3 weeks, was dictated by the primary procedure. There were no complications related to early weightbearing
  
  
  CONCLUSIONS
  The proximal tibia is a suitable and safe site for bone graft harvest for foot and ankle surgery. There is no need for additional restrictions in weightbearing after this procedure.
authors.affiliation: Avon Orthopaedic Center, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol BS10 5NB, United Kingdom. mike_whitehouse@yahoo.com
authors.forename: Michael R
authors.initials: MR
authors.lastname: Whitehouse
authors.forename: Ben J A
authors.initials: BJ
authors.lastname: Lankester
authors.forename: Ian G
authors.initials: IG
authors.lastname: Winson
authors.forename: Stephen
authors.initials: S
authors.lastname: Hepple
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000601:surgery*; D001174:Arthrodesis; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000601:surgery*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012189:Retrospective Studies; D013977:Tibia / Q000637:transplantation*; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D016474:Weight-Bearing