Ghassemi Alireza, Ghassemi Mehrangiz, Modabber Ali, Knobe Mathias, Fritz Ulrike, Riediger Dieter, Gerressen Marcus
Department of Oral, Maxillofacial and Plastic Facial Surgery, School of Medicine, University Hospital Aachen, Aachen, Germany.
Br J Oral Maxillofac Surg. 2013 Jun;51(4):e47-50. doi: 10.1016/j.bjoms.2012.04.257. Epub 2012 Jun 5.
The aim of this study was to evaluate the postoperative morbidity at the donor site and the long-term outcome after the harvest of bicortical iliac bone grafts, including the iliac crest and the anterior superior iliac spine (ASIS), by using a confirmed score. We retrospectively examined 54 consecutive patients who had had vascularised iliac bone grafts harvested to reconstruct different parts of the mandible. We used the Harris Hip Score to evaluate objectively the long-term postoperative morbidity at the donor site. Of 54 patients, 20 were female (37%) and 34 male (63%), with a mean age of 49 years (range 12-81). The causes of the bony defects were malignancy (n=37, 69%), benign tumours (n=7, 13%), osteomyelitis (n=9, 17%), and atrophy of the alveolar ridge (n=1, 2%). All transplants healed adequately. A total of 38/52 patients (73%) had a score of more than 80 points, which defines clinical success. Vascularised iliac bone grafts offer excellent bony dimensions with optimal shape to be used for reconstruction of different parts of the mandible. They can be harvested bicortically, including the iliac crest and the ASIS, with acceptable morbidity at the donor site. The Harris Hip Score is an appropriate tool for the evaluation of long-term impairment at the donor site after the harvest of vascularised iliac bone grafts, and it could be used to compare the results of different studies.
本研究的目的是通过使用一个已确认的评分系统,评估双皮质髂骨移植(包括髂嵴和髂前上棘)供区的术后发病率以及长期预后。我们回顾性研究了54例连续接受带血管蒂髂骨移植以重建下颌骨不同部位的患者。我们使用Harris髋关节评分来客观评估供区的术后长期发病率。54例患者中,女性20例(37%),男性34例(63%),平均年龄49岁(范围12 - 81岁)。骨缺损的原因包括恶性肿瘤(n = 37,69%)、良性肿瘤(n = 7,13%)、骨髓炎(n = 9,17%)和牙槽嵴萎缩(n = 1,2%)。所有移植均充分愈合。52例患者中有38例(73%)评分超过80分,这定义为临床成功。带血管蒂髂骨移植提供了极佳的骨尺寸和理想形状,可用于下颌骨不同部位的重建。它们可以双皮质方式获取,包括髂嵴和髂前上棘,供区发病率可接受。Harris髋关节评分是评估带血管蒂髂骨移植术后供区长期损伤的合适工具,可用于比较不同研究的结果。