The preparation of autogenous bone grafts with osteotomes

Emerged donor limb growth morbidity and malalignment after combined ipsilateral tibial and fibular cortical harvest graft in children. Early follow-up report

“…Larger bone graft requirements arise when the osseous defect is considerable, or the pathology necessitates enhanced osteosynthesis stimulus. Besides the fibula, the tibia as the supplementary donor offers several additional advantages: both sites can be harvested together; the tibia is subcutaneous anteromedially and easily assessed; the tibial cortical graft nearly matches its counterpart fibular graft length and strength; some medullary cancellous component is also available with the tibial graft [13,14,16]. Moreover, tibial regenerations are well documented in children [2,5,23].…”

“…Lately, several studies have reported donor site complications both in the short-and long-term after nonvascularized fibular grafts in children [8][9][10][11][12]. Contrarily, despite being in use for clinical practice for several decades, there is very limited literature on the subject of combined tibial and fibular harvesting [13][14][15]. Little is known about the donor site outcomes or morbidity following these dual harvests [5].…”

Progress in Orthopedic Surgery for 1941

“…Stuck 110 advocates removal of tibial grafts of the massive onlay type with an osteotome in preference to a motor saw. He states that the grafts removed in this manner have the advantage of raw irregular edges and are not devitalized by overheating.…”