Reconstruction of lateral humerus condylar defect using tricortical iliac crest graft: A case report

Abstract

Comminuted fractures of distal humerus are most commonly the result of high energy trauma. There is an extensive damage to soft tissues along with articular cartilage fragmentation and many a time associated with bone loss. Traditionally such bone voids are filled using a fibular strut graft. In this case report, reconstruction of lateral condyle of humerus, using a tricortical iliac crest graft has been described. A 37-year-old male sustained fracture of distal end of humerus with articular involvement of multifragmentary nature. There was severe comminution of the articular surface especially that of the lateral humerus condyle with bone void. To fill the bone void in the lateral column, tricortical iliac-crest graft was harvested from the ipsilateral iliac crest. Locking plates were applied medially and laterally, and fixation was done. After 6 months of follow-up, the patient showed good elbow range of motion (30 to 80 degrees) and the radiographs showed satisfactory union of the fracture with stable implants. There is also no significant graft donor site co-morbidity.For reconstruction of complex distal humerus fractures with bone void, tricortical iliac crest autologous bone graft can be considered as a feasible option apart from vascularised autologous bone graft and allograft. Keywords:tricortical iliac; bony defect;humerus fracture; autologous bone grafting