Donor site morbidity of anterior iliac crest for reconstruction of the jaw

Abstract

Introduction: The iliac crest has been the accepted place to obtain bone for reconstruction in oral and maxillofacial surgery. The iliac cres t has many advantages because of its accessibility, large amount of cancellous bone, relative ease of bone harvest, possibility of two tea m 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 Un iversity Hospital. Age, sex, size and kind of grafted bone, duration of pain on donor site, duration of gait disturbance, sensory defici t, 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 dis turbances and pain within 2 weeks and there was no correlation between the size of the harvesting block bone and the duration of gait disturb ance or pain. However, this study showed that the duration of pain is associated with gait disturbance. In addition, most patients had no complaints r egarding their surgical scar and contour defect, and only one patient had permanent impairment of the sensory function. Moreover, an iliac bone graft d id 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 pr ocedure with relatively low morbidity.