Use of the extensor, retinaculum as a donor site for bone-ligament-bone grafts

The recent introduction of bone-ligament-bone grafts for ligament reconstru ction in hand surgery has led to a search for suitable graft donor sites. T he extensor retinaculum had been suggested, but harvesting details were sti ll lacking. We therefore studied the anatomy of the extensor retinaculum, w ith radiography and morphometric measurements. Ten cadaver wrists were diss ected; the thick portion of the retinaculum and its insertions on the radiu s in the different extensor compartments were studied. The compartments wer e wire-marked, and AP radiographs taken of each specimen. The retinaculum s panning the first three compartments was removed with the bony ridges it in serted on, and the inter-ridge retinaculum length was measured. A compariso n of our dissections with the radiographs showed that only the radial compa rtments 1, 2 and 3 had constant bony insertions on both ridges, making them suitable for bone-ligament-bone grafting. The mean compartment length was 11.7 mm (compartment 1), 17 mm (compartment 2) and 7.3 mm (compartment 3) r espectively. Thus, the extensor retinaculum can be relied upon to provide b one-ligament-bone grafts from the first three compartments, for possible us e in ligament reconstructions in the hand and wrist.