Haws Lane, Ma Boyu, Godfrey Tanner, Waite Peter D, Kinard Brian, Powell Kathlyn
Resident, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
Resident, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
J Oral Maxillofac Surg. 2025 May 19. doi: 10.1016/j.joms.2025.05.006.
The iliac crest bone graft (ICBG) has long been considered the gold standard for secondary alveolar reconstruction in patients with cleft lip and palate. With the advent of grafting alternatives, such as bone morphogenetic protein-2, the morbidity of the iliac crest harvest has come into question.
The purpose of this study is to estimate the frequency, types, and identify risk factors for postoperative complications of the anterior ICBG hip donor site.
STUDY DESIGN, SETTING, SAMPLE: A retrospective cohort study of patients who received alveolar reconstruction with anterior ICBG by 2 surgeons over an 11-year period at the Children's of Alabama Hospital in Birmingham, Alabama, was conducted. Exclusion criteria included previous alveolar graft attempt, age greater than 18 years at the time of repair, or lack of postoperative follow-up.
The predictor variable was a set of risk factors associated with complications and included sex, age at surgery, and cleft type (unilateral vs bilateral).
The main outcome variable was donor site morbidity defined as the presence of complications, prolonged length of stay, or readmission. Complications included gait disturbance, transient hypoesthesia, and hypertrophic scar.
Covariates included length of follow-up and alveolar cleft graft timing (secondary vs tertiary).
Descriptive and bivariate analyses were completed. The level of statistical significance was P < .05.
The sample size was composed of 426 subjects with a mean age of 7.9 ± 2.3 years. Of the total subjects, 211 (49.5%) patients were male and 215 (50.5%) patients were female. Overall, 11 (2.6%) subjects experienced complications associated with the anterior iliac crest donor site. The most prevalent anterior iliac crest donor site complications included transient gait disturbance 0.7% (n = 3), hypertrophic scar 0.7% (n = 3), and transient hypoesthesia 0.5% (n = 2). One subject experienced prolonged length of stay, and none required readmission. There were no study variables associated with donor site morbidity.
The overall morbidity associated with anterior ICBG for alveolar cleft repair remains low, with a complication rate of 2.6% (n = 11) associated with the donor site. These results offer strong evidence of the overall safety and minor morbidity of the ICBG harvest for alveolar cleft repair.
长期以来，髂嵴骨移植（ICBG）一直被视为唇腭裂患者二期牙槽骨重建的金标准。随着骨形态发生蛋白-2等移植替代物的出现，髂嵴取骨的发病率受到了质疑。
本研究的目的是评估前ICBG髋部供区术后并发症的发生率、类型，并确定危险因素。
研究设计、设置、样本：对阿拉巴马州伯明翰市阿拉巴马儿童医院的2名外科医生在11年期间接受前ICBG牙槽骨重建的患者进行了一项回顾性队列研究。排除标准包括既往牙槽骨移植尝试、修复时年龄大于18岁或缺乏术后随访。
预测变量是一组与并发症相关的危险因素，包括性别、手术年龄和腭裂类型（单侧与双侧）。
主要结局变量是供区发病率，定义为出现并发症、住院时间延长或再次入院。并发症包括步态障碍、短暂性感觉减退和肥厚性瘢痕。
协变量包括随访时间和牙槽裂植骨时机（二期与三期）。
完成了描述性和双变量分析。统计学显著性水平为P <.05。
样本量由426名受试者组成，平均年龄为7.9±2.3岁。在所有受试者中，211名（49.5%）患者为男性，215名（50.5%）患者为女性。总体而言，11名（2.6%）受试者出现了与髂嵴前供区相关的并发症。最常见的髂嵴前供区并发症包括短暂性步态障碍0.7%（n = 3）、肥厚性瘢痕0.7%（n = 3）和短暂性感觉减退0.5%（n = 2）。1名受试者住院时间延长，无人需要再次入院。没有研究变量与供区发病率相关。
牙槽裂修复术中前ICBG相关的总体发病率仍然较低，供区并发症发生率为2.6%（n = 11）。这些结果为ICBG用于牙槽裂修复的总体安全性和轻微发病率提供了有力证据。
