Sangmin Ryan Shin1, Paul Tornetta. 1. *Boston University Medical Center, Boston, MA; and†Boston University School of Medicine, Boston, MA.
Abstract
OBJECTIVES: The objective of this study was to evaluate donor site morbidity associated with anterior iliac crest bone graft harvesting for orthopaedic trauma reconstructions. DESIGN: Retrospective case series. SETTING: Level 1 trauma center. PATIENTS: Forty-Six consecutive patients who had undergone anterior iliac crest bone graft harvesting more than a 7-year period were reviewed. INTERVENTION: 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. MAIN OUTCOME MEASURE: Visual analog scale and modified Questionnaires. RESULTS: 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. CONCLUSIONS: 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. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
OBJECTIVES: The objective of this study was to evaluate donor site morbidity associated with anterior iliac crest bone graft harvesting for orthopaedic trauma reconstructions. DESIGN: Retrospective case series. SETTING: Level 1 trauma center. PATIENTS: Forty-Six consecutive patients who had undergone anterior iliac crest bone graft harvesting more than a 7-year period were reviewed. INTERVENTION: 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. MAIN OUTCOME MEASURE: Visual analog scale and modified Questionnaires. RESULTS: 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. CONCLUSIONS: 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. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.