Ghassemi Alireza, Ghassemi Mehrangiz, Riediger Dieter, Hilgers Ralf-Dieter, Gerressen Marcus
Assistant Professor, Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of the Aachen University, Aachen, Germany.
J Oral Maxillofac Surg. 2009 Aug;67(8):1589-94. doi: 10.1016/j.joms.2009.04.013.
The objective of this study is to characterize the donor-site morbidity after harvesting of nonvascularized and vascularized iliac bone grafts.
Clinical data of 353 patients were collected for analysis. In addition, a questionnaire was sent to all patients asking about their perceptions of different parameters. In an individual age-matched layout, we compared 34 patients with nonvascularized iliac bone grafts with 34 patients with vascularized iliac bone grafts.
Transplantation of vascularized bone grafts has been increasingly performed at our institution. The mean age was 41.5 years in the nonvascularized group and 48.6 years in the vascularized group. The main reason for the bony defect in the vascularized group was malignancy. The majority of postoperative functional problems were observed in obese patients. No patient had serious or long-term complications at the donor site. The amount of bone graft taken affected postoperative sensitivity disturbance and caused postoperative functional problems and pain.
We conclude that the iliac crest is a suitable site for harvesting both vascularized and nonvascularized bone grafts measuring up to 10 x 3 cm. For larger defects that require a larger bone graft, a vascularized bone graft is more suitable with a better predictable healing capability. No significant differences in donor-site morbidity were found between the vascularized and nonvascularized bone grafts if a similar amount of bone was taken for transplant.
本研究的目的是描述非血管化和血管化髂骨移植术后供区并发症情况。
收集353例患者的临床资料进行分析。此外，向所有患者发放问卷，询问他们对不同参数的看法。在个体年龄匹配的布局中，我们将34例接受非血管化髂骨移植的患者与34例接受血管化髂骨移植的患者进行了比较。
在我们机构，血管化骨移植的应用越来越多。非血管化组的平均年龄为41.5岁，血管化组为48.6岁。血管化组骨缺损的主要原因是恶性肿瘤。术后大多数功能问题出现在肥胖患者中。没有患者在供区出现严重或长期并发症。所取骨移植量影响术后感觉障碍，并导致术后功能问题和疼痛。
我们得出结论，髂嵴是获取尺寸达10×3 cm的血管化和非血管化骨移植的合适部位。对于需要更大骨移植的较大骨缺损，血管化骨移植更合适，其愈合能力更可预测。如果移植时所取骨量相似，血管化和非血管化骨移植的供区并发症无显著差异。
