Joshi A, Kostakis G C
University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH.
Br Dent J. 2004 Feb 14;196(3):167-71; discussion 155. doi: 10.1038/sj.bdj.4810945.
A study which examined the morbidity experienced by patients who underwent iliac crest bone graft procedures.
A post-operative questionnaire was forwarded to patients who underwent iliac crest bone graft procedures at a single centre.
One hundred and fourteen patients underwent iliac crest bone grafts for intra-oral augmentation.
Ninety-eight patients (80%) returned post-operative questionnaires. Eighty of the 98 (81.6%) patients suffered post-operative pain with 70% of patients being pain-free after four weeks. However, 10% of patients experienced pain for more than 16 weeks. Eighty-five (86.7%) patients were able to walk without any difficulties six weeks post-operatively. Gait disturbance was not related with age, however there was a significant association between pain and disturbance of gait (P< 0.001). Twenty two patients required the use of a walking stick and the use of such aids varied from 0.5 to 26 weeks. Women used walking aids for longer periods than men (P< 0.05). Twenty five patients had altered sensation with about half of them experiencing altered sensation in the distribution of the lateral femoral cutaneous nerve. Other morbidities included deformity at the hip site (2.4%), haematoma (2.4%), infection (3.2%), stress fracture (4.1%) and meralgia paraesthetica in one patient. Despite the above morbidities, 82 patients were willing to undergo the same procedure again and 89 patients would recommend the procedure to their relatives and friends.
This study demonstrates considerable morbidity following anterior iliac crest bone harvest for intra-oral augmentation. Clinicians referring patients for such bone graft procedures must be aware of the above morbidities so that any patients referred for such procedures are fully informed.
一项研究对接受髂嵴骨移植手术的患者所经历的发病率进行了调查。
向在单一中心接受髂嵴骨移植手术的患者发送了术后调查问卷。
114例患者接受了髂嵴骨移植以进行口腔内增高术。
98例患者（80%）返回了术后调查问卷。98例患者中的80例（81.6%）术后疼痛，70%的患者在四周后无痛。然而，10%的患者疼痛持续超过16周。85例（86.7%）患者术后六周能够毫无困难地行走。步态障碍与年龄无关，然而疼痛与步态障碍之间存在显著关联（P<0.001）。22例患者需要使用拐杖，使用此类辅助器具的时间从0.5周到26周不等。女性使用辅助器具的时间比男性长（P<0.05）。25例患者感觉异常，其中约一半患者在股外侧皮神经分布区域感觉异常。其他发病率包括髋部畸形（2.4%）、血肿（2.4%）、感染（3.2%）、应力性骨折（4.1%）以及1例患者出现感觉异常性股痛。尽管有上述发病率，但82例患者愿意再次接受相同手术，89例患者会向其亲属和朋友推荐该手术。
本研究表明，为进行口腔内增高术而取自髂嵴前部的骨组织会导致相当多的发病率。将患者转介进行此类骨移植手术的临床医生必须了解上述发病率，以便让任何转介进行此类手术的患者充分知情。
