Bone graft from iliac bone for maxillofacial reconstruction : an operative approach with decrease morbidity

Abstract EN

Background : In Maxillofacial surgeries, iliac bone graft has traditionally been harvested to provide osteoconductive, osteoinductive and osteogenic components to initiate bony formation.

There are multiple types of procedures for harvesting iliac bone graft, either by surgical exposure procedure for procurement bone graft bicortical, unicortical, tricortical or by using Fritsch bone harvesting (trephine) system or by Spine-Tech grinding harvester technique.

This study compares procedures for harvesting iliac bone graft by using sub-crestal window technique procedure and trap-door iliac crest bone graft procedure for different purposes like alveolar cleft, bone resection due to tumor, reconstruction of avulsed facial bone due to trauma by bullet injury or RTA, confirming that donor site morbidity of the sub-crestal window technique is more significant than trap-door technique. Patients and methods : In this study (40 patients / 22♂ : 18♀) underwent harvesting of iliac bone graft with age range (3.5-65 years) in Al-Kadhmyea Teaching Hospital (2009-2012) for different purposes like alveolar cleft, reconstruction of mandible after tumor resection and reconstruction of maxillofacial defects due to massive blast or bullet injury. Results and Conclusions : The results indicate that major complications from ICBG harvest are uncommon, but minor complications are common.

The findings suggest that donor site morbidity of the sub-crestal window technique is significantly less than trapdoor technique.

Making the sub-crestal window technique is the method of choice for harvesting large amounts of bone graft.