Assessment of Ipsilateral Versus Contralateral Proximal Fibula for Use in Distal Radius Osteoarticular Reconstruction

Which fibula to harvest for distal radius reconstruc­tion, ipsilateral or contralateral, is subject to debate. In this study, we investigated which proximal fibula is better suited for distal radius osteoarticular reconstruc­tion based on radiographic parameters. Twenty-one proximal fibulas were harvested from adult cadavers. Radiographic fibular inclination angle (coronal plane) and radiographic fibular articular tilt (sagittal plane) were measured, and these parameters were compared with corresponding radius parameters. Mean radiographic fibular inclination angles were 25° (right) and 26° (left), and mean radiographic fibular articular tilts were 13° (right) and 13° (left). The native volar tilt of the radius is re-created when the ipsilateral proximal fibula (with proper styloid placement) is transferred to the ipsilateral wrist; conversely, a dorsal tilt is created when the con­tralateral proximal fibula is transferred. The ipsilateral proximal fibula is therefore a better radiographic match for distal radius osteoarticular reconstruction in the group we studied.