Hu R, Hearn T, Yang J
Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada.
Clin Orthop Relat Res. 1995 Jan(310):252-6.
Bone graft harvest site fracture can occur after removal of bone from the anterior iliac crest. No biomechanically proven guidelines for safe removal of bone exist. Cadaveric hemipelves were tested in a materials testing system machine, with the harvest site occurring 15-mm posterior to the anterosuperior iliac spine in 8 specimens and 30-mm posterior in 7 specimens. These pelves were then tested to failure by simulating avulsion fractures caused by the forces of the flexors of the hip. Average force at failure was 783 N (standard deviation, +/- 333 N) in the 15-mm group and 1917 N (standard deviation, +/- 735) in the 30-mm group. This study provides objective data which demonstrate that harvest 30 mm posterior to the anterosuperior iliac spine weakens the iliac crest less than harvest 15 mm posterior to the anterosuperior iliac crest. To minimize the possibility of iliac crest fracture after bone graft harvest, bone should be removed at least 30 mm from the anterior superior iliac spine.
取自髂前嵴的骨移植供骨部位骨折可能发生在从髂前嵴取骨之后。目前尚无经生物力学验证的安全取骨指南。在材料测试系统机器上对尸体半骨盆进行测试，8个标本的取骨部位位于髂前上棘后方15毫米处，7个标本的取骨部位位于髂前上棘后方30毫米处。然后通过模拟髋部屈肌力量导致的撕脱骨折来对这些半骨盆进行破坏测试。15毫米组的平均破坏力量为783牛（标准差，±333牛），30毫米组为1917牛（标准差，±735牛）。本研究提供了客观数据，表明在髂前上棘后方30毫米处取骨比在髂前上棘后方15毫米处取骨对髂嵴的削弱更小。为了将骨移植后髂嵴骨折的可能性降至最低，应在距髂前上棘至少30毫米处取骨。
