Donor site morbidity of anterior iliac crest for reconstruction of the jaw

Abstract

(J Korean Assoc Oral Maxillofac Surg 2010;36:380-4) Ⅰ. 서 론 Daegu,[700][701][702][703][704][705] The iliac crest has been the accepted place to obtain bone for reconstruction in oral and maxillofacial surgery. The iliac crest has many advantages because of its accessibility, large amount of cancellous bone, relative ease of bone harvest, possibility of two team approach and ability to close the wound primarily. This study evaluated retrospectively the morbidity of bone harvesting from the anterior iliac crest to provide a logical guide for recognizing the complications and morbidities of an iliac crest bone graft. Materials and Methods: Fifty healthy patients (mean age of 35.5 years; range 7 to 59) underwent iliac crest bone harvesting for a maxillofacial reconstruction from January 2007 to September 2009 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University Hospital. Age, sex, size and kind of grafted bone, duration of pain on donor site, duration of gait disturbance, sensory deficit, scar, contour defect were measured in each patients by retrospective research. Results:The mean duration of pain is 6.7 days, and mean duration of gait disturbance is 7.2 days. Most patients were free from gait disturbances and pain within 2 weeks and there was no correlation between the size of the harvesting block bone and the duration of gait disturbance or pain. However, this study showed that the duration of pain is associated with gait disturbance. In addition, most patients had no complaints regarding their surgical scar and contour defect, and only one patient had permanent impairment of the sensory function. Moreover, an iliac bone graft did not extend the length of hospitalization. Conclusion:This study suggests that split thickness bone harvesting from the inner table of the anterior iliac crest is a well accepted procedure with relatively low morbidity.

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

“…Other factors may include 'rigid' immobilization of the graft on a reconstruction plate, prophylactic antibiotic administration, extended postoperative antibiotic use and probably the benign nature of the lesions in most of our subjects. Lee et al 17 corroborated our findings in their retrospective review of donor-site morbidity of anterior iliac crest for reconstruction of the jaw, and concluded that split-thickness bone harvest from the inner table of the anterior iliac crest is a well-accepted procedure with relatively low morbidity. Lee et al 17 , however, retained the outer split portion of the iliac crest in situ (only using the inner half for mandibular reconstruction), while both inner and outer halves were utilized in our study.…”

“…This ultimately reduces donor site morbidity. A 'split iliac crest bone graft' has been described by Lee et al 17 for mandibular reconstruction. The length of the defect created following ablation in our study ranged from 4 to 12 cm.…”