Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

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

장골이식 공여부의 합병증 및 후유증에 관한 후향적 연구

  • Lee, Seung-Hun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyungpook National University) ;
  • Choi, So-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyungpook National University) ;
  • Kim, Hyun-Soo (Department of Dentistry, Kumi Cha Hospital) ;
  • Kwon, Tae-Geon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyungpook National University) ;
  • Kim, Chin-Soo (Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyungpook National University) ;
  • Lee, Sang-Han (Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyungpook National University) ;
  • Jang, Hyun-Jung (Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyungpook National University)
  • 이승훈 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 최소영 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 김현수 (구미 차병원 치과학교실) ;
  • 권대근 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 김진수 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 이상한 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 장현중 (경북대학교 치과대학 구강악안면외과학교실)
  • Received : 2010.06.09
  • Accepted : 2010.10.22
  • Published : 2010.10.29
Download PDF
⟨ Previous Next ⟩

Abstract

Introduction: 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.

Keywords

References

  1. Marx RE. Philosophy and particulars of autogenous bone grafting. Oral Maxillofac Surg Clin North Am 1993;5:599-612.
  2. Kalk WW, Raghoebar GM, Jansma J, Boering G. Morbidity from iliac crest bone harvesting. J Oral Maxillofac Surg 1996;54:1424- 9. https://doi.org/10.1016/S0278-2391(96)90257-8
  3. Kang JY, Kim KW, Lee EY, Choi HW. A study of anatomy for fracture of iliac bone as graft donor site. J Korean Assoc Maxillofac Plast Reconstr Surg 2004;26:75-80.
  4. Rudman RA. Prospective evaluation of morbidity associated with iliac crest harvest for alveolar cleft grafting. J Oral Maxillofac Surg 1997;55:219-23; discussion 223-4. https://doi.org/10.1016/S0278-2391(97)90528-0
  5. Rawashdeh MA. Morbidity of iliac crest donor site following open bone harvesting in cleft lip and palate patients. Int J Oral Maxillofac Surg 2008;37:223-7. https://doi.org/10.1016/j.ijom.2007.11.009
  6. Converse JM, Wood-Smith D, Macomber WB, Wang MKH. Deformities of the lips and cheeks. Converse JM, McCarthy JG, Littler JW, eds. Reconstructive plastic surgery: principles and procedures in correction, reconstruction and transplantation. Vol 3. 2nd ed. Philadelphia: W.B. Saunders Co.; 1977:1470-9.
  7. Ryu SY, Kim IK, Kim JC, Oh HK, Park KW. Reconstruction of mandibular bone defect with autogenous iliac bone graft. Case reports and review of literature. J Korean Assoc Oral Maxillofac Surg 1986;12:65-74.
  8. Wilk RM. Bony reconstruction of the jaws. In: Miloro M, ed. Peterson's principles of oral and maxillofacial surgery. 2nd ed. Hamilton: BC Decker Co.; 2004:789-91.
  9. Hall MB, Vallerand WP, Thopmson D, Hartley G. Comparative anatomic study of anterior and posterior iliac crests as donor sites. J Oral Maxillofac Surg 1991;49:560-3. https://doi.org/10.1016/0278-2391(91)90335-J
  10. Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedure: a prospective study. Int J Oral Maxillofac Surg 2004;33:157-63. https://doi.org/10.1054/ijom.2003.0465
  11. Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg 1996;25:268-71. https://doi.org/10.1016/S0901-5027(06)80053-6
  12. van der Wal KG, de Visscher JG, Stoelinga PJ. The autogenous inner table iliac bone graft. A review of 100 patients. J Maxillofac surg 1986;14:22-5. https://doi.org/10.1016/S0301-0503(86)80253-3
  13. Mrazik J, Amato C, Leban S, Mashberg A. The ilium as a source of autogenous bone for grafting: clinical consideration. J Oral Surg 1980;38:29-32.
  14. Mischkowski RA, Selbach I, Neugebauer J, Koebke J, Zo¨ller JE. Lateral femoral cutaneous nerve and iliac crest bone graftsanatomical and clinical considerations. Int J Oral Maxillofac Surg 2006;35:366-72. https://doi.org/10.1016/j.ijom.2005.08.010
  15. Russel JL, Block JE. Surgical harvesting of bone graft from the ilium: point of view. Med Hypotheses 2000;55:474-9. https://doi.org/10.1054/mehy.2000.1095
  16. Dawson KH, Egbert MA, Myall RW. Pain following iliac crest bone grafting of alveolar clefts. J Craniomaxillofac Surg 1996; 24:151-4.
  17. Kim DH, Rhim R, Li L, Martha J, Swaim BH, Banco RJ, et al. Prospective study of iliac crest bone graft harvest site pain and morbidity. Spine J 2009;9:886-92. https://doi.org/10.1016/j.spinee.2009.05.006
  18. Cricchio G, Lundgren S. Donor site morbidity in two different approaches to anterior iliac crest bone harvesting. Clin Implant Dent Relat Res 2003;5:161-9. https://doi.org/10.1111/j.1708-8208.2003.tb00198.x
  19. Swan MC, Goodacre TE. Morbidity at the iliac crest donor site following bone grafting of the cleft alveolus. Br J Oral Maxillofac Surg 2006;44:129-33. https://doi.org/10.1016/j.bjoms.2005.04.015
  20. Baqain ZH, Anabtawi M, Karaky AA, Malkawi Z. Morbidity from anterior iliac crest bone harvesting for secondary alveolar bone grafting: an outcome assessment study. J Oral Maxillofac Surg 2009;67:570-5. https://doi.org/10.1016/j.joms.2008.09.023
  21. Kessler P, Thorwarth M, Bloch-Birkholz A, Nkenke E, Neukam FW. Harvesting of bone from the iliac crest-comparison of the anterior and posterior sites. Br J Oral Maxillofac Surg 2005;43:51-6. https://doi.org/10.1016/j.bjoms.2004.08.026