TechniquesIliac Crest Bone Graft With Intramedullary Headless Implant for Metacarpal Bone LossMilhoan, Madison MD; Hoelscher, Victoria MD; Pientka, William F. II MD Author Information JPS Health Network Department of Orthopaedic Surgery, Fort Worth, TX Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to JPS Health Network Department of Orthopaedic Surgery, 1500 S. Main St, Fort Worth, TX 76104. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery 27(2):p 120-124, June 2023. | DOI: 10.1097/BTH.0000000000000421 Buy Metrics Abstract Metacarpal bone loss presents a challenging reconstructive dilemma for hand surgeons. While multiple bone grafting techniques have been described, complications including nonunion, graft resorption, fixation requiring prolonged immobilization, stiffness, and the need for multiple procedures are well-documented. We present a technique for managing metacarpal bone loss utilizing a tri-cortical iliac crest graft and an intramedullary metacarpal nail for the treatment of metacarpal fractures and nonunions that is technically simple, fast, and allows for early initiation of motion to decrease postoperative complications. Level of Evidence: Level IV- Therapeutic Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.