Harvesting Iliac Bone Graft: Decreasing the Morbidity

1999 ◽  
Vol 36 (5) ◽  
pp. 388-390 ◽  
Author(s):  
Jorge I. de la Torre ◽  
Mayer Tenenhaus ◽  
Pamela M. Gallagher ◽  
Stephen A. Sachs
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Iliac Crest ◽  
Skin Incision ◽  
Iliac Bone ◽  
Pain Disability ◽  
Graft Harvest ◽  
Iliac Bone Graft ◽  
Classic Technique ◽  
Abundant Supply

Objective: This is a review of modifications made to the classic technique for harvesting bone graft from the iliac crest. Prior techniques for harvesting iliac bone often resulted in significant postoperative pain, disability, and a cosmetically unacceptable scar and contour deformity. Design: A retrospective review of patients who underwent bone graft harvest over a 7-year period was done. Interventions: The modifications described use a skin incision medial to the anterior superior iliac crest. The medial aspect of the iliac crest is elevated along the midsagital axis of the crest. The medial cap is reflected outward, exposing cancellous bone. Results: A review of 51 patients demonstrated only two minor self-limiting complications. Conclusions: This procedure provides an abundant supply of both cortical and cancellous bone, an aesthetically acceptable scar, and decreased patient discomfort.

Optimizing Safety of Iliac Bone Harvest Using an Acumed Drill: A Simulated Radiographic Study of 100 Patients

2017 ◽  
Vol 54 (6) ◽  
pp. 674-679 ◽  
Author(s):  
John T. Stranix ◽  
Daniel Cuzzone ◽  
Catherine Ly ◽  
Nicole Topilow ◽  
Christopher M. Runyan ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cortical Thickness ◽  
Cancellous Bone ◽  
Reference Point ◽  
Iliac Crest ◽  
Bowel Perforation ◽  
Iliac Bone ◽  
Iliac Crest Bone Graft ◽  
Visceral Injury ◽  
Graft Harvest

Objective To determine the potential risk of visceral injury during Acumed drill iliac crest cancellous bone graft harvest. Design Radiographic iliac crest anatomic analysis with simulated drill course to measure cancellous bone available for harvest and proximity of vulnerable pelvic structures. Setting Single institution, tertiary care university hospital. Patients and Participants One hundred pelvic computed tomography scans performed on children 8 to 12 years old without traumatic or neoplastic pathology. Interventions Radiographic simulation of Acumed drill course within iliac bone. Main Outcome Measures (1) Potential for pelvic visceral injury. (2) Volume of cancellous bone safely available for harvest. Results Superior and medial cortical thickness at the reference point remained stable across age groups; however, lateral cortical thickness increased with age (3.13 to 3.74 mm, P < .001). Cancellous bone width increased with age at all depths measured ( P < .001). Through radiographic simulation, the drill could reach the bowel in 4% of cases and only through gross deviation (>30°) from the plane of the ilium. There were no cases of simulated bowel perforation within 3 cm of the reference point. The maximum cancellous volume safely harvested increased with age: 24 cc in 8-year-olds to 36 cc in 12-year-olds ( P < .001). Conclusions Acumed assisted iliac crest bone graft harvest is a safe technique in which substantial amount of cancellous bone can be obtained. The low risk of bowel perforation can be further minimized by limiting the depth of drill bit penetration to less than 3 cm.

Trochanteric Bone Grafts in Foot and Ankle Surgery

1996 ◽  
Vol 17 (7) ◽  
pp. 402-405 ◽  
Author(s):  
W. Richard Hayes ◽  
Ronald W. Smith
Keyword(s):  
Bone Graft ◽  
Delayed Union ◽  
Iliac Bone ◽  
Patient Questionnaire ◽  
Foot And Ankle ◽  
Greater Trochanter ◽  
Graft Harvest ◽  
Iliac Bone Graft ◽  
Ankle Surgery

Eighty-five patients who underwent trochanteric bone graft harvest in association with foot and ankle surgery were studied retrospectively by patient questionnaire. The average follow-up was 49 months (range, 14–101 months). Ninety-five percent of the patients expressed satisfaction with the procedure, in that they would choose to accept the trochanteric bone graft again if required to make the choice. However, 31 % of the patients acknowledged some degree of hip discomfort and 4% reported some daily pain. Nineteen of 85 patients (22%) were treated for trochanteric pain. Most patients responded to strengthening/stretching and heat/ice. Four patients (5%) had failed or delayed union of the arthrodesis in which trochanteric bone graft was utilized. The greater trochanter may be considered as an alternative for major bone graft when the iliac bone is not available and when weightbearing is restricted for at least 6 weeks after surgery. As with the use of iliac bone graft, patients should be alerted to the possibility of postoperative discomfort. Surgical details should be followed to minimize the risk of peritrochanteric fracture.

scholarly journals Lumbar and para-iliac hernias: an alternative technique

2021 ◽  
Vol 48 ◽  
Author(s):  
MARIA PESSOLE BIONDO SIMÕES ◽  
ALEXANDRE CONTIN MANSUR ◽  
SILVANIA KLUG PIMENTEL
Keyword(s):  
Bone Graft ◽  
Blunt Trauma ◽  
Iliac Crest ◽  
Aortic Surgery ◽  
Iliac Bone ◽  
Lumbar Region ◽  
Alternative Technique ◽  
Iliac Bone Graft ◽  
The Mean

ABSTRACT Lumbar and para-iliac hernias are rare and occur after removal of an iliac bone graft, nephrectomies, retroperitoneal aortic surgery, or after blunt trauma to the abdomen. The incidence of hernia after the removal of these grafts ranges from 0.5 to 10%. These hernias are a problem that surgeons will face, since bone grafts from the iliac crest are being used more routinely. The goal of this article was to report the technique to correct these complex hernias, using the technique of fixing the propylene mesh to the iliac bone and the result of this approach. In the period of 5 years, 165 patients were treated at the complex hernia service, 10 (6%) with hernia in the supra-iliac and lumbar region, managed with the technique of fixing the mesh to the iliac bone with correction of the failure. During the mean follow-up of 33 months (minimum of 2 and maximum of 48 months), there was no recurrence of the hernias.

scholarly journals Possibility of Using Flexible Dentures over Iliac Bone Graft in Adolescent Patients with Ameloblastoma: A 9-Month Follow-Up Clinical Report

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Ammar Belal ◽  
Bassil Monther ◽  
Wael Alzarif
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Clinical Observation ◽  
Transition Period ◽  
Iliac Bone ◽  
Clinical Report ◽  
Common Procedure ◽  
Iliac Bone Graft ◽  
Adolescent Patients

Introduction. The use of bone grafts is a common procedure after excision and reconstruction of the mandible, although it is rare in children and adolescents due to incomplete growth, which means a long transition period until reaching an appropriate age for implants or more predictable outcomes. Case Report. This article describes a 9-month follow-up of the use of a flexible denture above a bone graft taken from the anterior iliac crest for adolescent patients with resected mandible due to ameloblastoma. Taking into account prosthetic considerations, radiography, and clinical observation, no complications were seen with the graft. Conclusion. It is safe to use a flexible denture as a prosthetic over an iliac bone graft block during the healing period.

Quantitative Analysis of Cancellous Bone Graft Available from the Greater Trochanter

1996 ◽  
Vol 17 (8) ◽  
pp. 473-476 ◽  
Author(s):  
Eric J. Lindberg ◽  
Stuart D. Katchis ◽  
Ronald W. Smith
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Proximal Femur ◽  
Iliac Crest ◽  
Secondary Source ◽  
Cancellous Bone Graft ◽  
Greater Trochanter ◽  
Graft Harvest ◽  
Digital Compression ◽  
Trochanteric Region

To quantify the amount of cancellous bone graft available from the greater trochanteric region, 20 paired iliac crest-proximal femur specimens were harvested and compared in 10 adult pelvises. A 1.3 × 1.3-cm cortical window was made in the lateral aspect of the proximal femur 2 cm distal from the tip of the greater trochanter. Cancellous bone evacuation was performed by curettage. The extent of harvest was mechanically limited by the medial wall of the trochanter and by curette impingement on the margins of the cortical window. The graft was quantitated after maximal digital compression in a 10-ml syringe and compared with cancellous graft obtained from the paired anterior iliac crest. The average compressed volume of cancellous bone harvested from the greater trochanter was 6.5 ml (range, 4.2–9.6 ml). The average iliac crest cancellous bone volume was 6.0 ml (range, 2.7–8.8 ml). Differences in graft volume between the anterior iliac crest and the trochanter were not statistically significant. The resulting defect in the proximal femur remained isolated to the trochanteric region. In this study, we demonstrate that cancellous bone is available from the greater trochanteric region in an amount similar to that available from the anterior iliac crest. We also show that it is obtainable in a reproducible manner. Our clinical experience of over 100 cases has demonstrated acceptable morbidity associated with this technique. The greater trochanteric region may be used as a secondary source of autogenous cancellous bone graft when specific procedures demand more bone graft than available from the iliac crest alone, or in patients who have had previous iliac crest graft harvest.

scholarly journals Lumbar Incisional Hernia Repair following Iliac Bone Graft Harvest

2014 ◽  
Vol 4 (2) ◽  
pp. 379-382 ◽  
Author(s):  
Ketan Vagholkar ◽  
◽  
Abhijit Budhkar ◽  
Jagruti Gulati ◽  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Bone Graft ◽  
Incisional Hernia Repair ◽  
Iliac Bone ◽  
Graft Harvest ◽  
Iliac Bone Graft

Rehabilitation of Severely Atrophied Mandible Using Free Iliac Crest Bone Grafts and Dental Implants: Report of Two Cases

2007 ◽  
Vol 33 (3) ◽  
pp. 122-126 ◽  
Author(s):  
Orhan Güven
Keyword(s):  
Bone Graft ◽  
Dental Implants ◽  
Iliac Crest ◽  
Bone Grafts ◽  
Mandibular Reconstruction ◽  
Iliac Bone ◽  
First Case ◽  
Facial Esthetics ◽  
Iliac Bone Graft

Abstract The purpose of this study was to reveal the improvement in facial esthetics and maintenance of mastication in severely atrophied mandibles with inadequate alveolar ridges in 2 patients. Bone graft harvested from iliac crest was used for the reconstruction in the first case, followed by the application of 2 dental implants after 6 months. A free iliac bone graft and 2 dental implants were also used simultaneously with a 1-stage surgery in the second case; the patient had previously had a mandibular reconstruction with a rib graft. Both of the patients achieved remarkably functional and esthetic improvements after treatment. Free iliac bone graft is considered to be a favorable alternative for the maintenance of satisfactory functional and esthetic results in patients with severely atrophied alveolar ridges.

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