Chen Xin, Chen Kai, Su Yuxi
Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Department II of Orthopedics, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, China.
J Orthop Surg Res. 2021 Mar 3;16(1):169. doi: 10.1186/s13018-021-02318-4.
The iliac crest is one of the most used bone graft sources. In this study, we aimed to identify the effects of inner side and two-sided approaches for iliac crest bone harvesting on post-surgery ilium growth in children.
We retrospectively analyzed 47 patients who underwent pelvic osteotomy and iliac crest bone graft (ICBG) procedures from January 2015 to September 2018. The patients were divided into an inner table ilium exposure group (group A) and the inner-outer table ilium exposure group (group B) and were followed up with radiography in postoperative months 1, 3, 6, and 12, and the growth areas were measured using PACS software. Complications such as damage to the arteries or nerves, ureteral injury, gastrointestinal hernia, ileus, abnormal cosmetic appearance, sensory disturbances, and functional limitations were recorded based on clinical records.
There were 22 patients aged 5.3±1.5 years in group A and 25 patients aged 5.9±1.8 years in group B. There were no significant differences in demographics between the two groups, or in growth in the first month. However, bone graft growth at months 3, 6, and 12 was significantly better in group A than in group B. There was no significant difference in complications between the two groups.
Exposure of only the inner table of the ilium resulted in faster recovery of the bone defect than two-sided exposure in pelvic osteotomy. Therefore, we suggest protecting the outer side of the ilium during surgery.
Level III.
髂嵴是最常用的骨移植来源之一。在本研究中，我们旨在确定儿童髂嵴取骨的内侧入路和双侧入路对术后髂骨生长的影响。
我们回顾性分析了2015年1月至2018年9月期间接受骨盆截骨术和髂嵴骨移植（ICBG）手术的47例患者。将患者分为内板髂骨暴露组（A组）和内外板髂骨暴露组（B组），并在术后1、3、6和12个月进行X线随访，使用PACS软件测量生长区域。根据临床记录记录动脉或神经损伤、输尿管损伤、胃肠道疝、肠梗阻、外观异常、感觉障碍和功能受限等并发症。
A组22例患者，年龄5.3±1.5岁；B组25例患者，年龄5.9±1.8岁。两组患者的人口统计学特征以及第一个月的生长情况均无显著差异。然而，A组在术后3、6和12个月时的骨移植生长情况明显优于B组。两组并发症发生率无显著差异。
在骨盆截骨术中，仅暴露髂骨内板比双侧暴露能使骨缺损恢复更快。因此，我们建议在手术过程中保护髂骨外侧。
三级。
