Bone-Graft Harvesting From Iliac and Fibular Donor Sites: Techniques and Complications

Ebraheim, Nabil A.; Elgafy, Hossein; Xu, Rongming

doi:10.5435/00124635-200105000-00007

Cited by 212 publications

(118 citation statements)

References 26 publications

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“…Many potential donor sites are available for graft harvest, all with recognized major and minor complications [1,4,7,20,23,27]. Sources of relatively large amounts of bone graft (ie, 20-40 cc) are the anterior iliac crest, posterior iliac crest, and the fibula.…”

Section: Introductionmentioning

confidence: 99%

“…Sources of relatively large amounts of bone graft (ie, 20-40 cc) are the anterior iliac crest, posterior iliac crest, and the fibula. Harvesting bone graft from these sites can result in complications such as residual pain, injury to the lateral femoral cutaneous nerve anteriorly, injury to the superficial peroneal nerves at the region of the fibula, and injury to the superior cluneal nerves in the region of the posterior iliac crest [4]. Other major complications include abdominal hernias, sacroiliac joint injuries, avulsion fractures of the anterior iliac spine, and vascular injury to the superior gluteal artery [4].…”

Section: Introductionmentioning

confidence: 99%

“…Harvesting bone graft from these sites can result in complications such as residual pain, injury to the lateral femoral cutaneous nerve anteriorly, injury to the superficial peroneal nerves at the region of the fibula, and injury to the superior cluneal nerves in the region of the posterior iliac crest [4]. Other major complications include abdominal hernias, sacroiliac joint injuries, avulsion fractures of the anterior iliac spine, and vascular injury to the superior gluteal artery [4]. Despite all these complications, these areas provide excellent bone graft and are the only sources of tricortical bone graft when immediate structural stability is required [4].…”

Section: Introductionmentioning

confidence: 99%

“…Other major complications include abdominal hernias, sacroiliac joint injuries, avulsion fractures of the anterior iliac spine, and vascular injury to the superior gluteal artery [4]. Despite all these complications, these areas provide excellent bone graft and are the only sources of tricortical bone graft when immediate structural stability is required [4].…”

Section: Introductionmentioning

confidence: 99%

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Bone Graft Harvest Using a New Intramedullary System

Belthur

Conway

Jindal

et al. 2008

Clinical Orthopaedics &Amp; Related Research

145

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Obtaining autogenous bone graft from the iliac crest can entail substantial morbidity. Alternatively, bone graft can be harvested from long bones using an intramedullary (IM) harvesting system. We measured bone graft volume obtained from the IM canals of the femur and tibia and documented the complications of the harvesting technique. Donor site pain and the union rate were compared between the IM and the traditional iliac crest bone graft (ICBG) harvest. Forty-one patients (23 male, 18 female) with an average age of 44.9 years (range, 15-78 years) had graft harvested from long bones using an IM harvest system (femoral donor site, 37 patients; tibial donor site, four patients). Forty patients (23 male, 17 female; average age, 46.4 years; range, 15-77 years) underwent anterior ICBG harvest. We administered patient surveys to both groups to determine pain intensity and frequency. IM group reported lower pain scores than the ICBG group during all postoperative periods. Mean graft volume for the IM harvest group was 40.3 mL (range, 25-75 mL) (graft volume was not obtained for the ICBG group). Using an intramedullary system to harvest autogenous bone graft from the long bones is safe provided a meticulous technique is used.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bone Graft Harvest Using a New Intramedullary System

Belthur

Conway

Jindal

et al. 2008

Clinical Orthopaedics &Amp; Related Research

145

View full text Add to dashboard Cite

show abstract

“…2,11,[13][14][15][16][17] However, studies have associated ICBG harvesting with significant donor-site morbidity, including neurologic and vascular injury, incisional hernia, donor-site fracture, and deep infection. [21][22][23][24] Therefore, the purpose of this article was to describe a surgical technique developed to reduce donor-site morbidity and improve functional outcomes after open reductioneinternal fixation with autologous bone graft placement through local autograft harvesting and concurrent plate fixation. …”

mentioning

confidence: 99%

Treatment of Midshaft Clavicle Fractures: Application of Local Autograft With Concurrent Plate Fixation

Slette

Mikula

Turnbull

et al. 2016

Arthroscopy Techniques

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Abstract:Currently, open reductioneinternal fixation using contoured plates or intramedullary nails is considered the standard operative treatment for midshaft clavicle fractures because of the immediate rigid stability provided by the fixation device. In addition, autologous iliac crest bone graft has proved to augment osteosynthesis during internal fixation of nonunion fractures through the release of osteogenic factors. The purpose of this article is to describe a surgical technique developed to reduce donor-site morbidity and improve functional and objective outcomes after open reductioneinternal fixation with autologous bone graft placement through local autograft harvesting and concurrent plate fixation.T he clavicle is one of the most commonly fractured bones, representing 5% to 15% of all fractures. 1 Fractures of the midshaft account for approximately 80% of all clavicular fractures because the junction between the lateral and middle third is the thinnest portion of the bone and lacks muscular and ligamentous reinforcement. 2,3 Historically, fractures of the middle third of the clavicle were managed nonoperatively because closed treatment was believed to yield a low nonunion rate and minimal functional impairment. 4 In addition, clavicular malunion, which occurs to some degree in approximately two-thirds of midshaft clavicle fractures, was previously described as being solely a radiographic anomaly with no clinical significance. 2,5-8 However, more recent studies have suggested that operative treatment results in increased patient satisfaction, superior functional capabilities, and decreased rates of nonunion and malunion when compared with nonoperative management. [9][10][11][12] Operative management of midshaft clavicle fractures may involve the use of various techniques for reduction and fixation. 12 Currently, open reductioneinternal fixation is considered the gold-standard treatment because of the immediate rigid stability provided by the fixation device. 2,11,[13][14][15][16][17] Internal fixation of midshaft clavicle fractures may involve the use of contoured plates or intramedullary nails. [18][19][20] In addition, autologous iliac crest bone graft (ICBG) has proved to augment osteosynthesis during fixation of nonunion fractures through the release of osteogenic factors. 2,11,[13][14][15][16][17] However, studies have associated ICBG harvesting with significant donor-site morbidity, including neurologic and vascular injury, incisional hernia, donor-site fracture, and deep infection. [21][22][23][24] Therefore, the purpose of this article was to describe a surgical technique developed to reduce donor-site morbidity and improve functional outcomes after open reductioneinternal fixation with autologous bone graft placement through local autograft harvesting and concurrent plate fixation.

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