Eufinger H, Leppänen H
Department of Oral & Maxillofacial Surgery, Ruhr-University, Bochum, Germany.
J Craniomaxillofac Surg. 2000 Feb;28(1):31-8. doi: 10.1054/jcms.2000.0105.
Donor site morbidity after bone harvesting still remains a crucial problem in alveolar cleft osteoplasty. This study focuses on ilium donor site morbidity comparing two different techniques. A series of 52 consecutive patients was divided in half. All had anterior iliac crest bone grafts. In the study group the harvesting was performed with a closed osteotomy using a cylindrical Shepard osteotome. The control group underwent the traditional open osteotomy. In the open osteotomy group the short-term morbidity at the donor site was slightly greater than in the closed harvesting group. The low short-term morbidity in the closed harvesting group was reflected in the analgesic consumption which was three times higher in the open osteotomy group (p < 0.008). The most striking difference occurred in the appearance of the mature scar: a length of 24.2 mm (mean) in the closed harvesting group against 60.3 mm in the open osteotomy group (p < 0.0001), and a width of 4.9 mm (mean) versus 7.7 mm, respectively (p < 0.003). The long-term morbidity was negligible in both groups. Based on these findings we suggest that bone harvesting from the anterior iliac crest remains the preferred method, provided that closed harvesting is undertaken.
在牙槽嵴裂骨成形术中，取骨后供骨部位的并发症仍然是一个关键问题。本研究聚焦于比较两种不同技术下的髂骨供骨部位并发症情况。连续纳入52例患者并将其平均分为两组。所有患者均接受了髂前嵴骨移植。研究组采用闭合截骨术，使用圆柱形谢泼德骨凿取骨。对照组采用传统的开放截骨术。在开放截骨组，供骨部位的短期并发症略高于闭合取骨组。闭合取骨组较低的短期并发症反映在镇痛药物的消耗量上，开放截骨组的消耗量是其3倍（p < 0.008）。最显著的差异出现在成熟瘢痕的外观上：闭合取骨组瘢痕长度平均为24.2 mm，而开放截骨组为60.3 mm（p < 0.0001），宽度分别为4.9 mm（平均）和7.7 mm（p < 0.003）。两组的长期并发症均可忽略不计。基于这些发现，我们建议，只要采用闭合取骨，髂前嵴取骨仍是首选方法。
