A comparison of parietal and iliac crest bone grafts for orbital reconstruction

Abstract

Purpose: This study evaluated the results of cranial (membranous) versus iliac crest (endochondral) bone grafts as implants to correct post-traumatic globe malposition and/or diplopia. Patients and Methods: Twenty-two patients underwent 25 orbital reconstructions with bone for enophthalmos, hypophthalmos, and diplopia after trauma to the orbit. Inclusion criteria consisted of at least 4 months postsurgical follow-up, pre- and postsurgical quantitative orbital measurements, photographic documentation, and complete medical records regarding inpatient and outpatient data. Results: Nine cranial bone grafts and 16 iliac crest grafts were placed. Ages were similar in both groups. The average follow-up was 24 months for the cranial graft group (range, 4 to 54 months) and 18 months for the iliac crest graft group (range, 4 to 51 months). Preoperative enophthalmos averaged 4.11 and 5.06 mm in the cranial and iliac crest groups, respectively, and postoperatively the measurements were 1.78 and 1.37 mm, respectively. Changes in hypophthalmos generally reflected changes in the enophthalmos correction. In 10 patients diplopia was corrected by the procedure. There was a statistically significant change in the enophthalmos of patients when comparing pre- and postoperative status, but no statistically significant difference between the results of the cranial and iliac crest graft groups. Conclusion: There is no difference in the ability of cranial and iliac crest bone grafts to correct post-traumatic enophthalmos. © 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:44-50, 2002