Experience with Alternative Sources of Structural Bone Graft for Total Wrist Fusion in Three Rheumatoid Arthritis Patients

Abstract

Three cases are presented in which alternative sources of bone graft were used for wrist fusion; in two cases, frozen irradiated allograft was implanted, and in one, stored frozen autogenous bone harvested from the patient during a previous procedure was used. All cases were followed clinically and radiologically for at least one year. The frozen banked allograft and autograft were not successful when used as structural grafts to bridge a defect for wrist fusion; however, allograft implantation resulted in successful wrist fusion where host bone contact across the fusion site was maintained, and the allograft was used to fill a defect. Fresh autogenous bone remains the structural graft of choice for wrist fusion in the rheumatoid patient in the few cases where graft is required for this diagnosis. Morsellized frozen allograft can be employed to fill dead space.