Iliac Bone Autograft Research Articles

Strategy of craniofacial reconstruction after resection of spheno-orbital "en plaque" meningiomas.

Surgical resection of spheno-orbital "en plaque" meningiomas should be as complete as possible to prevent tumor recurrence and therefore requires a bone reconstruction. We report a series of 20 patients operated on for spheno-orbital "en plaque" meningioma between 1981 and 1993. The surgical treatment included a resection of the involved dura and a wide resection of tumoral bone using a fronto-temporal craniotomy extended to the orbitozygomaticomalar bone ridge. The craniofacial reconstruction was performed in the same operative procedure using iliac bone autograft in 11 patients, internal cortical bone from the bone flap in 8 patients, and a coral graft in 1 patient. The cosmetic result was scored according to the following criteria: superior frontal paralysis, appearance of the orbitomalar bone ridge, shape of the external temporal fossa, and projection of the eyeballs. The cosmetic result was scored as excellent or good in 17 patients, average in 2 patients, and poor in 1 patient. The iliac bone autograft appeared to be the best material for craniofacial reconstruction because it could be modeled easily to the desired shape. However, the reconstruction technique was modified as necessary according to the extent of tumor removal, clinical presentation, and age of the patient.

Surgical treatmant of scoliosis using frame design

Surgical treatment results of 56 patients with dysplastic scoliosis of IV degree were analysed. Follow up period ranged from 1 to 6.5 years (mean 4.3 years). In all cases the posterior approach was used. In 22 patients (1st group) two distraction rods, similar to Harringtons ones, were placed along both sides of the curvature, fixed to the posterior vertebral elements using end hooks and tightened between each other by wires. Posterior spondylodesis was performed using cortical allografts. In 24 patients (2nd group) and 10 patients (3rd group) the distraction rods were connected to each other by stiff transverse stays. In the 2nd group the posterior spondylodesis was performed with allografts, in the 3rd group - iliac bone autografts. No principal difference in the volume of surgical correction was noted in those groups but in the 3rd group the surgical correction was slightly higher. Operative correction loss was the highest in the 1st group (main curvature - 71%, pathologic rotation - 100%) and in the 3rd group the operative correction loss was the lowest one (25% and 80%, respectively). Authors explained those results by the advantages of stiff implanted design and the more fast reconstruction of the autografts. Authors consider that the indication to use this method is scoliosis with the 50 -70 deformity and mobile main curvature arch.

A Comparison of Iliac and Cranial Bone in Secondary Grafting of Alveolar Clefts

This retrospective study compares the success of iliac versus cranial bone autografts in the secondary grafting of alveolar clefts. The study group was 116 patients with complete records and radiographs from a pool of 186 consecutively grafted patients at Children's Hospital of Philadelphia. The quality of graft "take" was graded radiologically. Variables potentially influencing outcome were evaluated and included graft type (iliac versus cranial bone), cleft type (unilateral versus bilateral), cleft severity (complete unilateral or bilateral cleft lip and palate versus cleft of the alveolus only), age at grafting, and complications. Although graft "take" versus "nontake" seemed comparable in iliac and cranial bone graft groups, iliac bone showed a statistical superiority over cranial bone, with more radiologically excellent grades (p = 0.04) in all cleft types. Likewise, when the two graft types were compared in more severe clefts (complete unilateral and bilateral cleft lip and palate), iliac bone showed statistical superiority (p = 0.02) over cranial bone. However, they seemed comparable in less severe clefts of the alveolus only (p = 0.22). Recipient-site complications and their sequelae were comparable in iliac versus cranial graft groups, and no age-related differences were noted in children grafted above or below age 10.

The Fate of Free, Pedicled and Free Vascularized Cancellous Iliac Bone Grafts and the Effect on the Healing of Femoral Osteotomy: An Experimental Study

A new model for vascularized and nonvascularized iliac bone autograft transfer to a femoral shaft osteotomy site is presented in this experimental study. As demonstrated on roentgenograms taken at 4 to 6 weeks postoperatively, callus formation between vascularized grafts and recipient sites was 1.5 to 2 times faster than in the nonvascularized graft transfer. According to densitometric analysis, conventional free grafts lost more hydroxyapatite and restored their mineral structure at a slower rate than vascularized grafts. There was no difference between free vascularized and pedicled grafts in the rate of mineral deposition changes, but the pedicle grafts had more significant loss of bone density. Formation and mineralization of periosteal callus between the femoral-shaft fragments took place more rapidly in the first 12 weeks after pedicled bone transplantation. The correlation between the densitometric results and morphologic behavior of transplanted bones was examined. It was demonstrated that all of the grafts at the recipient site underwent remodeling into cortical bone. However, vascularized, and especially pedicled, grafts maintained their cancellous structure relatively longer.

下顎骨に発症した歯原性粘液腫の１例

Myxoma is a. comparatively rare disease occurring in jaw bone. We encountered a 17-year-old girl who developed odontogenic myxoma from the region of the right lower second premolar to the right mandibular ramus.The patient appeared at our department with gingival swelling at the right lower molar region.Biopsy revealed histopathological evidence of odontogenic epithelium and myxomatous tissue.The lesion was managed by mandibulectomy under general anesthesia, immediately followed by reconstruction using A-O reconstruction plate and iliac bone autograft. This surgical intervention was satisfactory. No recurrence was found 4 years after surgery. Ninety-eight cases of myxoma of the jaw reported in literature were reviewed and the present case was comparatively discussed.