Bone donor site - Iliac crest or distal radius?

In a series of 18 patients requiring bone-grafting procedures to the wrist, bone structure and bone turnover characteristics were compared between samples of bone harvested from the iliac crest and the distal radius. Histologically and biologically the iliac crest bone was found to be superior to distal radial bone. Axial bone was also shown to be more resistant to the ravages of increasing age and chronic disease. However, in spite of these laboratory findings, clinically, radial bone is equally successful as graft material. This, in all probability, is due to the greater porosity of radial bone which allows better compaction, more accurate filling of defects and easier nourishment of the graft by surrounding body fluids.