Shin Sangmin Ryan, Tornetta Paul
*Boston University Medical Center, Boston, MA; and†Boston University School of Medicine, Boston, MA.
J Orthop Trauma. 2016 Jun;30(6):340-3. doi: 10.1097/BOT.0000000000000551.
The objective of this study was to evaluate donor site morbidity associated with anterior iliac crest bone graft harvesting for orthopaedic trauma reconstructions.
Retrospective case series.
Level 1 trauma center.
Forty-Six consecutive patients who had undergone anterior iliac crest bone graft harvesting more than a 7-year period were reviewed.
Grafts were taken by removing the inner table of the ilium from 2 cm posterior to the Anterior Superior Iliac Spine. The abductor insertion was left intact and the external contour of the ilium remained unaffected.
Visual analog scale and modified Questionnaires.
Thirty-seven of the 46 patients were evaluated at average follow-up of 4.5 years after anterior iliac bone graft harvesting for nonunion or fusion for posttraumatic arthrosis. No patient complained of pain at final follow-up with all patients having a visual analog scale pain of 0 at final follow-up. Three patients reported some scar numbness, however, none complained of thigh numbness. Three patients, if they needed grafting in the future would seek alternative sources based on their remembrance of significant postoperative pain.
Anterior inner table bone graft harvesting resulted in minimal morbidity and neither pain nor functional limitations at an average of 4.5 years. This technique has lower donor-site morbidity than previous reports of posterior graft sites.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
本研究的目的是评估与用于骨科创伤重建的髂嵴前部取骨相关的供区并发症。
回顾性病例系列研究。
一级创伤中心。
回顾了46例在7年多时间内接受髂嵴前部取骨的连续患者。
通过从髂前上棘后方2 cm处去除髂骨内板来获取骨移植材料。外展肌附着点保持完整,髂骨的外部轮廓未受影响。
视觉模拟评分法和改良问卷。
46例患者中有37例在髂骨前部取骨后平均4.5年进行了评估,评估内容为骨不连或创伤后关节炎融合情况。在最后随访时,没有患者抱怨疼痛,所有患者在最后随访时视觉模拟评分法疼痛评分为0。3例患者报告有一些瘢痕麻木,但无人抱怨大腿麻木。3例患者表示,如果未来需要植骨,基于对术后明显疼痛的记忆,他们会寻求其他来源。
髂骨前部内板取骨导致的并发症极少,平均4.5年时既无疼痛也无功能受限。与先前关于后部供区的报道相比,该技术的供区并发症更低。
治疗性四级证据。有关证据级别的完整描述,请参阅《作者须知》。