Pedicled iliac crest bone flap transfer for the treatment of upper femoral shaft fracture nonunion: An anatomic study and clinical applications

Zhao, Dewei; Cao, Meng; Wang, Tienan; Wang, Benjie; Lineaweaver, William C.

doi:10.1002/micr.30278

Cited by 2 publications

(1 citation statement)

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“…Due to the anatomical advantages of the iliac bone flap, it is widely used in the reconstruction and repair of the whole body [ 17 – 20 ]. With the development of microsurgical techniques, iliac bone flap transplantation with anterolateral anatomy of deep circumflex iliac vessels was proposed to repair femoral head necrosis [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of retrograde anatomy iliac bone flap grafting versus anterograde anatomy iliac bone flap grafting for treatment of osteonecrosis of the femoral head

Xiao

Qing

et al. 2023

J Orthop Surg Res

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Background Iliac bone flap with deep circumflex iliac artery is a common option in the treatment of Osteonecrosis of the femoral head (ONFH), and dissection of iliac bone flap is the key step for successful operation. This paper aims to introduce a new operative technique for dissecting iliac bone flap with deep circumflex iliac artery based on analysis of its advantages. Methods A total of 49 patients treated by retrograde anatomy and 52 patients treated by anterograde anatomy from January 2010 to December 2020 were recruited. The two groups were then compared in terms of the preoperative baseline conditions, intraoperative data, and postoperative Harris hip score (HHS). Results Compared with the retrograde anatomy group, the anterograde anatomy group had a significantly longer operating time, a significantly heavier intraoperative blood loss, a significantly higher rate of donor complication morbidity, a significantly higher rate of donor–recipient delayed healing, a significantly higher failure rate of iliac bone flap resection, a significantly higher rate of lateral femoral cutaneous nerve (LFCN) injury, and a significantly higher rate of ectopic ossification. No difference was found in postoperative HHS score between the two groups. Conclusion As a new operative technique that can accurately locate the nutrient vessels of the iliac bone flap and quickly dissect the iliac bone flap with deep circumflex iliac artery while maintaining a comparable clinical effect, retrograde anatomy exhibited distinct advantages over anterograde anatomy in terms of simpler intraoperative operation, safer dissection, shorter operation time, lower blood loss, and fewer donor complications. Level of evidence III, Retrospective.

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Section: Introductionmentioning

confidence: 99%