Modified iliac bone harvesting--morbidity and patients' experience

J Oral Maxillofac Surg. 2009 Aug;67(8):1700-5. doi: 10.1016/j.joms.2009.03.022.

Abstract

Purpose: The aim of the present retrospective study was to evaluate the postoperative morbidity and patients' satisfaction after harvesting a bicortical bone graft from the anterior iliac wing using a modified surgical technique.

Materials and methods: Between 1996 and 2006, 36 patients underwent bicortical bone block harvesting procedures from the ilium with subsequent bone augmentation of the jaws under general anesthesia at the Department of Oral Surgery, Medical University Graz. A modification of the harvesting technique proposed by Tayapongsak et al was used. Of the 36 patients, 32 participated in the present retrospective study. The clinical trial was based on the evaluation of the clinical records, a follow-up examination of the donor site, and the patient's personal assessment of the course of therapy.

Results: Apart from 1 postoperative hematoma, 1 infected wound, and 1 postoperative seroma that had to be treated, no intra- or postoperative complications developed. At 3 to 14 days (mean 11.06) after the surgical procedure, the patients were free of pain. Gait disturbance was present for an average of 14 days. The clinical follow-up examination at the donor region was without any pathologic findings. The patients' personal assessment of the therapy course revealed high acceptance: 84% would agree to the same treatment if they had to choose, and 87% would recommend this treatment to other patients. On a pain scale of 1 to 10, the overall therapy course was assessed at an average of 1.77.

Conclusions: Iliac bone grafts are the treatment of choice to reconstruct extensive maxillary defects. This retrospective evaluation revealed minor complications and morbidity and high patient acceptance, supporting its use.

MeSH terms

  • Adult
  • Alveolar Ridge Augmentation / methods
  • Bone Transplantation
  • Drug Combinations
  • Electrocoagulation
  • Female
  • Follow-Up Studies
  • Gait Disorders, Neurologic / etiology
  • Gelatin Sponge, Absorbable / therapeutic use
  • Hematoma / etiology
  • Hemostasis, Surgical
  • Hemostatics / therapeutic use
  • Humans
  • Ilium / surgery*
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Pain Measurement
  • Palmitates / therapeutic use
  • Patient Satisfaction
  • Postoperative Complications
  • Postoperative Hemorrhage / etiology
  • Retrospective Studies
  • Seroma / etiology
  • Surgical Wound Infection / etiology
  • Tissue and Organ Harvesting / adverse effects*
  • Tissue and Organ Harvesting / methods
  • Waxes / therapeutic use
  • Young Adult

Substances

  • Drug Combinations
  • Hemostatics
  • Palmitates
  • Waxes
  • bone wax