Journal List > J Korean Assoc Oral Maxillofac Surg > v.36(5) > 1032416

Lee, Choi, Kim, Kwon, Kim, Lee, and Jang: Donor site morbidity of anterior iliac crest for reconstruction of the jaw

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.

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Fig. 1.
Duration of the pain in the total group of 50 patients.
jkaoms-36-380f1.tif
Fig. 2.
Duration of gait disturbance in the total group of 50
jkaoms-36-380f2.tif
Fig. 3.
Scatter diagram for the duration of pain on donor site and the size of harvesting block bone.(R=0.137, P>0.05)
jkaoms-36-380f3.tif
Fig. 4.
Scatter diagram for the period of gait disturbance and the size of harvesting block bone.(R=0.083, P>0.05)
jkaoms-36-380f4.tif
Fig. 5.
Scatter diagram for the period of gait disturbance and the duration of pain.(R=0.524, P<0.05)
jkaoms-36-380f5.tif
Fig. 6.
Scatter diagram for the period of gait disturbance and the length of hospitalization.(R=0.015, P>0.05)
jkaoms-36-380f6.tif
Table 1.
Mean duration of gait disturbance and pain according to type of harvesting method of iliac bone
  Harvesting method of iliac bone
Corticocancellous block bone (n=39) Cancellous bone only (n=11)
Mean duration of Pain 7.4 days 4.6 days
Mean duration of Gait disturbance 7.5 days 5.2 days

(P > 0.05)

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