Clarke A, Flowers M J, Davies A G, Fernandes J, Jones S
Department of Orthopaedics, Sheffield Children's Hospital, Sheffield, UK.
Department of Orthopaedics, Al Ahli Hospital, Doha, Qatar.
J Child Orthop. 2015 Oct;9(5):411-6. doi: 10.1007/s11832-015-0698-0. Epub 2015 Oct 5.
Autologous iliac crest bone grafting is an integral part of many orthopaedic surgical procedures. Several studies have documented morbidity and prolonged pain following iliac crest bone graft harvesting in adults; however, in children there is a paucity of information. The purpose of the present study was to quantify the degree of pain and morbidity associated with anterior iliac crest graft harvesting in children undergoing non-spinal orthopaedic surgery.
Patients were prospectively enrolled prior to orthopaedic surgery. A patient self-reported visual analogue score was used to record pain at specified time points following surgery. In addition, the patients were reviewed at 2 and 6 weeks, 3 months and 1 year after surgery to record any complications.
Data was collected on 33 patients (34 graft sites). Only one patient (2.94 %) had a complication, namely an injury to the lateral femoral cutaneous nerve. This resolved 3 months after surgery. 89 % of patients had no pain at the iliac crest graft harvest site 3 months after surgery. The three patients who had pain at 3 months had visual analogue scores of 1.0, 1.1 and 1.3, respectively.
This series reveals a very low complication rate and minimal iliac crest graft harvest site pain in children undergoing non-spinal orthopaedic surgery. In addition, the pain experienced is short-lived.
自体髂嵴骨移植是许多骨科手术的重要组成部分。多项研究记录了成人髂嵴取骨后出现的并发症及长期疼痛;然而,关于儿童的相关信息却很少。本研究的目的是量化接受非脊柱骨科手术的儿童进行髂嵴前部取骨时的疼痛程度和并发症情况。
在骨科手术前对患者进行前瞻性纳入。采用患者自我报告的视觉模拟评分来记录术后特定时间点的疼痛情况。此外,在术后2周、6周、3个月和1年对患者进行复查,以记录任何并发症。
收集了33例患者(34个取骨部位)的数据。仅1例患者(2.94%)出现并发症,即股外侧皮神经损伤,该并发症在术后3个月得到缓解。89%的患者在术后3个月时髂嵴取骨部位无疼痛。3个月时有疼痛的3例患者视觉模拟评分分别为1.0、1.1和1.3。
该系列研究显示,接受非脊柱骨科手术的儿童并发症发生率极低,髂嵴取骨部位疼痛轻微。此外,所经历的疼痛是短暂的。