Comparative clinicoanatomical study of ilium and fibula as two commonly used bony donor sites for maxillofacial reconstruction

Sönmez, Tolga Taha; Prescher, Andreas; Salama, Andrew; Kanatas, Anastasios; Zor, Fatih; Mitchell, David A.; Shahrak, Arash Zaker; Karaaltın, Mehmet Veli; Knobe, Matthias; Külahçi, Yalçın; Altuntaş, Selman Hakkı; Ghassemi, Alireza; Hölzle, Frank

doi:10.1016/j.bjoms.2013.07.010

Cited by 10 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The osteocutaneous scapula flap is the flap of choice for composite tissue reconstruction because of its ability to transfer a variety of bone, muscle and skin paddles. We already presented in comparative anatomical studies the relevant thickness, width, and height of the commonly used bone flaps for dental implants . Evaluating the overall implantability (a minimal vertical height of ≥10 mm and a transversal bone width of ≥5.5 mm was considered) of the bone segments at 4 MPs on the shaft of fibula, we found that the fibula was reliable bone stock.…”

Section: Discussionmentioning

confidence: 99%

Morphological and morphometric evaluation of the ilium, fibula, and scapula bones for oral and maxillofacial reconstruction

Shahrak

Zor²,

Kanatas

et al. 2014

Microsurgery

Self Cite

View full text Add to dashboard Cite

This study aimed to evaluate the osteometric boundaries of the ilium, fibula, and scapula beyond which reconstruction of oromandibular and craniofacial defects, using these free flaps, may not be optimal. Fibula, scapula, and iliac bones were obtained bilaterally from 33 female and 27 male European adult cadavers (n = 60). Adapting classical anthropometric methods to surgical needs by modifying the measuring bone localizations and measurement points, a measuring system of osteometry and morphometry was used, to quantify the usable bone length of the iliac crest, fibula, and lateral border of the scapula and to localize an oval region (OR) in the ilium. The thin, translucent OR of ilium was localized 62.4 ± 5.6 mm posterior to the maximum concavity between the anterior superior (ASIS) and anterior inferior iliac spine and 26.7 ± 6 mm caudal to the intermediate line of the iliac crest. The available iliac crest was measured from ASIS to the posterior superior iliac spine (PSIS) 247.5 ± 12.6 mm, fibula supplied 170.2 ± 19.1 mm harvestable bone, and the lateral border of the scapula 94.3 ± 8.5 mm [Corrected]. The OR influenced the harvestable bone shape and volume of the ilium. Measuring of the localization points of OR, we found that the size of the OR was very variable and that the height of the neomandible reconstructed with iliac crest might alter with aging. Our findings contribute with knowledge of detailed morphometric measurements on commonly used donor bones to the planning strategies of volumetric defects in oral and maxillofacial region by precise osteometric localization method of OR and relativized length measurements.

show abstract

Section: Discussionmentioning

confidence: 99%

Morphological and morphometric evaluation of the ilium, fibula, and scapula bones for oral and maxillofacial reconstruction

Shahrak

Zor²,

Kanatas

et al. 2014

Microsurgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Third, we should also consider the topographical anatomy of the nourishing vessels along the inner surface of the ilium, which lie between 5 mm and 20 mm below the crest (Urken et al, ; Ting et al, ; Ghassemi et al, ). Many previous studies have also reported the BT of the ilium, but they measured areas that would never be used clinically (Beckers et al, ; Shimizu et al, ; Khamanarong et al, ; Sönmez et al, ). The average BT of usable bone from ASIS to posterior was greater than 5.75 mm, making it suitable for dental implantation.…”

Section: Discussionmentioning

confidence: 99%

“…). However, studies emphasizing flaps with a bony component have focused on the generally available amount of bone regardless of its real clinical usability (Frodel et al, ; Beckers et al, ; Shimizu et al, ; Khamanarong et al, ; Sönmez et al, ; Zaker Shahrak et al, ). To our knowledge, there has to date been no comparative study of clinically usable bone dimensions in the two most important flaps for mandibular reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Regions of ilium and fibula providing clinically usable bone for mandible reconstruction: “A different approach to bone comparison”

et al. 2016

Self Cite

View full text Add to dashboard Cite

A variety of donor sites are available for mandibular reconstruction. We present here a different way of comparing two commonly-used bone flaps. The lengths of the usable parts in a total of 241 coxal bones, 91 mandibles and 60 fibulas were measured. The mandible was measured from condyle-to-condyle and the harvestable bone length (HBL) and usable (UBL) bone lengths in fibula and ilium were also measured. The bone thickness (BT) in 60 iliac crests was measured in two parallel lines from the anterior superior iliac spine (ASIS) along the iliac crest. The mandible was 32.17 mm shorter in females than in males. The total ilium UBL was 171.12 mm in females and 178.80 mm in males. The mean HBL of the fibula was 22.6 mm shorter in females than in males. However, in some fibulas in both females and males, only 4.2% and 21.1% of the HBL respectively could be used if the ultimate goal was to insert dental implants. We found significant correlations between BT and gender in both fibula and ilium (P≤ 0.05). The ilium offers constant BT throughout the usable bone area with a similar bone length to the fibula. In contrast, the fibula showed variable bone dimensions, so not all of it is clinically usable. This should especially be considered in females when a mandibular reconstruction is planned with the goal of occlusal rehabilitation. Clin. Anat. 29:773-778, 2016. © 2016 Wiley Periodicals, Inc.

show abstract

“…Margins for protected spaces may be defined to prevent the method from using bone where harvesting is not permitted. From a clinical perspective, the stability of the ankle joint or the knee would be compromised if too much fibular bone is harvested …”

Section: Methodsmentioning

confidence: 99%

“…Protected margins at the fibula were set in the present study to 70 mm from both the ankle and knee . This constraint was implemented to only allow clinically feasible transplant sections to be selected, because a literature survey showed common recommendations for protected margins of between 6 and 8 cm …”

Section: Methodsmentioning

confidence: 99%

Introduction of an algorithm for planning of autologous fibular transfer in mandibular reconstruction based on individual bone curvatures

Raith

Rauen

Möhlhenrich

et al. 2018

Robotics Computer Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Comparative clinicoanatomical study of ilium and fibula as two commonly used bony donor sites for maxillofacial reconstruction

Cited by 10 publications

References 20 publications

Morphological and morphometric evaluation of the ilium, fibula, and scapula bones for oral and maxillofacial reconstruction

Morphological and morphometric evaluation of the ilium, fibula, and scapula bones for oral and maxillofacial reconstruction

Regions of ilium and fibula providing clinically usable bone for mandible reconstruction: “A different approach to bone comparison”

Introduction of an algorithm for planning of autologous fibular transfer in mandibular reconstruction based on individual bone curvatures

Contact Info

Product

Resources

About