Donor site complications following anterior iliac crest bone graft for treatment of distal radius fractures

Objective: To compare the postoperative donor site morbidity and alveolar bone graft results following two different techniques for iliac crest bone graft harvest: a closed (Shepard's osteotome) and an open (trapdoor flap) technique. Design: A retrospective review of two cohorts of alveolar bone grafts performed from 1998 to 2004 in Birmingham Children's Hospital by two surgeons using different harvest techniques. Medical and nursing anesthetic notes and medication charts were reviewed. Alveolar bone graft results were assessed using preoperative and postoperative radiographic studies. Patients: A total of 137 patients underwent an operation. Of these, 109 patients were compatible with the inclusion criteria (data available, first operation, no multiple comorbidities). Sixty-four patients had iliac bone harvested using the open trapdoor technique, while 45 had the same procedure using the closed osteotomy technique. Results: Maximum bone graft volumes harvested were similar with both techniques. The mean length of hospital stay was 50.9 hours for the osteotome and 75.5 hours for the open technique group (p < .0001). The postoperative analgesia requirement was higher and the postoperative mobilization was delayed and more difficult for the open technique patients (p < .0005). Kindelan scores performed by two independent orthodontists were similar for both techniques. Conclusion: The findings demonstrate that harvesting bone from the iliac crest using an osteotome technique reduces time in hospital, analgesia requirements, and postoperative donor site morbidity with no detrimental outcome.

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A Comparison of the Use of Distal Radius Vascularised Bone Graft and Non-Vascularised Iliac Crest Bone Graft in the Treatment of Non-Union of Scaphoid Fractures

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408090400 ◽

2008 ◽

Vol 33 (5) ◽

pp. 636-640 ◽

Cited By ~ 37

Author(s):

J. BRAGA-SILVA ◽

F. M. PERUCHI ◽

G. M. MOSCHEN ◽

D. GEHLEN ◽

A. V. PADOIN

Keyword(s):

Bone Graft ◽

Distal Radius ◽

Iliac Crest ◽

Surgical Techniques ◽

Functional Results ◽

Iliac Crest Bone Graft ◽

Radiographic Findings ◽

Non Union ◽

Vascularised Bone Graft ◽

Mean Time

We compared two surgical techniques for the treatment of scaphoid non-union, namely, using distal radius vascularised bone graft and iliac crest non-vascularised bone graft. Eighty patients with symptomatic scaphoid non-union underwent surgical treatment, including 35 patients treated with distal radius vascularised bone graft and 45 treated by iliac crest non-vascularised bone graft. Patients were assessed objectively by examination of wrist range of motion, grip strength and radiographic findings in the postoperative period after a mean time of 2.8 (1.4) (range 1–5.2) years. Similar functional results were obtained with the two techniques. All cases of non-union in the non-vascularised group obtained consolidation in a mean time of 8.89 (2.26) months and in the vascularised group in a mean time of 7.97 (3.06) months. Three cases of consolidation failure occurred in the vascularised group and were related to technical difficulties.

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Use of Bone-Graft Substitutes in Distal Radius Fractures

Journal of the American Academy of Orthopaedic Surgeons ◽

10.5435/00124635-199909000-00001 ◽

1999 ◽

Vol 7 (5) ◽

pp. 279-290 ◽

Cited By ~ 74

Author(s):

Amy L. Ladd ◽

Nathan B. Pliam

Keyword(s):

Bone Graft ◽

Distal Radius ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Bone Graft Substitutes

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Use of bone graft substitute in the treatment for distal radius fractures in elderly

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-012-1057-1 ◽

2012 ◽

Vol 23 (6) ◽

pp. 651-656 ◽

Cited By ~ 11

Author(s):

Chintan Hegde ◽

Vishvas Shetty ◽

Sandeep Wasnik ◽

Imthiaz Ahammed ◽

Vijay Shetty

Keyword(s):

Bone Graft ◽

Distal Radius ◽

Bone Graft Substitute ◽

Distal Radius Fractures ◽

Radius Fractures

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Clostridium Perfringens Infection of an Anterior Iliac Crest Bone Graft Donor Site A Case Report

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199308000-00034 ◽

1993 ◽

Vol &NA; (293) ◽

pp. 265???268

Author(s):

STUART D. MILLER ◽

BERTON R. MOED ◽

JOSEPH L. CHESS

Keyword(s):

Case Report ◽

Bone Graft ◽

Clostridium Perfringens ◽

Iliac Crest ◽

Donor Site ◽

Iliac Crest Bone Graft ◽

Graft Donor

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USE OF THE VOLAR FIXED ANGLE PLATE FOR COMMINUTED DISTAL RADIUS FRACTURES AND AUGMENTATION WITH A HYDROXYAPATITE BONE GRAFT SUBSTITUTE

Hand Surgery ◽

10.1142/s0218810411005023 ◽

2011 ◽

Vol 16 (01) ◽

pp. 29-37 ◽

Cited By ~ 7

Author(s):

Akira Goto ◽

Tsuyoshi Murase ◽

Kunihiro Oka ◽

Hideki Yoshikawa

Keyword(s):

Elderly Patients ◽

Bone Graft ◽

Distal Radius ◽

Bone Graft Substitute ◽

Distal Radius Fractures ◽

Ulnar Variance ◽

Radius Fractures ◽

Fixed Angle ◽

Radial Inclination ◽

Metaphyseal Comminution

Treatment of distal radius fractures with a volar fixed angle plate achieves sufficient stabilisation and permits early physical exercise. However, secondary displacement after surgery sometimes occurs in elderly patients with a metaphyseal comminution and/or cases in which the subchondral support pegs were not placed immediately below the subchondral zone.We treated elderly patients suffering from distal radius fractures with metaphyseal comminution, using both volar fixed angle plate with or without augmentation with a hydroxyapatite bone graft substitute to investigate the benefit of augmentation for maintaining a fracture reduction. We evaluated the differences among radiographic parameters including palmar tilt, radial inclination, and ulnar variance on immediate postoperative and final follow-up radiographs to analyse the maintenance of the initial reduction.There were no significant differences between the two groups in terms of palmar tilt (P = 0.80) and radial inclination (P = 0.17); however, ulnar variance increased significantly in the group treated with a volar fixed angle plate without augmentation (P < 0.05).It might be useful to use a combination technique of a locking plate system and the hydroxyapatite bone graft substitute as augmentation to treat distal radius comminuted fractures in elderly patients.

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