장골이식 공여부의 합병증 및 후유증에 관한 후향적 연구
Donor site morbidity of anterior iliac crest for reconstruction of the jaw
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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.
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.
참고문헌 (21)
- Marx RE, "Philosophy and particulars of autogenous bone grafting", Oral Maxillofac Surg Clin North Am, 5, pp.599~612 (1993)
- Kalk WW, "Morbidity from iliac crest bone harvesting", J Oral Maxillofac Surg, 54, pp.1424~1429 (1996)
- 강지연, "골이식 공여부에 발생한 장골골절의 해부학적 고찰", 대한악안면성형재건외과학회지, 26(1), pp.75~80 (2004), 대한악안면성형재건외과학회
- Rudman RA, "Prospective evaluation of morbidity associated with iliac crest harvest for alveolar cleft grafting", J Oral Maxillofac Surg, 55, pp.219~224 (1997)
- Rawashdeh MA, "Morbidity of iliac crest donor site following open bone harvesting in cleft lip and palate patients", Int J Oral Maxillofac Surg, 37, pp.223~227 (2008)
- Converse JM, "Deformities of the lips and cheeks. In: Reconstructive plastic surgery: principles and procedures in correction, reconstruction and transplantation. Vol 3. 2nd ed", pp.1470~1479 (1977), W.B. Saunders Co
- Ryu SY, "Reconstruction of mandibular bone defect with autogenous iliac bone graft. Case reports and review of literature", J Korean Assoc Oral Maxillofac Surg, 12, pp.65~74 (1986)
- Wilk RM, "Bony reconstruction of the jaws. In: Peterson’s principles of oral and maxillofacial surgery. 2nd ed", pp.789~791 (2004), BC Decker Co
- Hall MB, "Comparative anatomic study of anterior and posterior iliac crests as donor sites", J Oral Maxillofac Surg, 49, pp.560~563 (1991)
- Nkenke E, "Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedure: a prospective study", Int J Oral Maxillofac Surg, 33, pp.157~163 (2004)
- Beirne JC, "Donor site morbidity of the anterior iliac crest following cancellous bone harvest", Int J Oral Maxillofac Surg, 25, pp.268~271 (1996)
- van der Wal KG, "The autogenous inner table iliac bone graft. A review of 100 patients", J Maxillofac surg, 14, pp.22~25 (1986)
- Mrazik J, "The ilium as a source of autogenous bone for grafting: clinical consideration", J Oral Surg, 38, pp.29~32 (1980)
- Mischkowski RA, "Lateral femoral cutaneous nerve and iliac crest bone graftsanatomical and clinical considerations", Int J Oral Maxillofac Surg, 35, pp.366~372 (2006)
- Russel JL, "Surgical harvesting of bone graft from the ilium: point of view", Med Hypotheses, 55, pp.474~479 (2000)
- Dawson KH, "Pain following iliac crest bone grafting of alveolar clefts", J Craniomaxillofac Surg, 24, pp.151~154 (1996)
- Kim DH, "Prospective study of iliac crest bone graft harvest site pain and morbidity", Spine J, 9, pp.886~892 (2009)
- Cricchio G, "Donor site morbidity in two different approaches to anterior iliac crest bone harvesting", Clin Implant Dent Relat Res, 5, pp.161~169 (2003)
- Swan MC, "Morbidity at the iliac crest donor site following bone grafting of the cleft alveolus", Br J Oral Maxillofac Surg, 44, pp.129~133 (2006)
- Baqain ZH, "Morbidity from anterior iliac crest bone harvesting for secondary alveolar bone grafting: an outcome assessment study", J Oral Maxillofac Surg, 67, pp.570~575 (2009)
- Kessler P, "Harvesting of bone from the iliac crest-comparison of the anterior and posterior sites", Br J Oral Maxillofac Surg, 43, pp.51~56 (2005)