Technical note: medial approach for proximal tibia bone graft using a manual trephine

Tibial Cancellous Bone Grafting in Jaw Reconstruction: 10 Years of Experience in Taiwan

“…Neither Rubel and colleagues' cadaver study nor our clinical experiences concord with the claims made by Lezcano and colleagues and Jakse and colleagues …”

“…As branches of recurrent tibial vessels and nerves course through the anterior tibial muscle, some surgeons also advocate the medial approach to reduce the risk of injury to the nerves and vessels. The authors cannot agree with this statement, as neither Catone and colleagues nor Brutus and Loftus described stripping or incising the anterior tibial muscle in their techniques while approaching laterally.…”

Proximal tibial bone graft: the volume of cancellous bone, and strength of decancellated tibias by the medial approach

“…CATONE et al 3 reported the use of the proximal tibial metaphysis as cancellous bone graft in orthognathic surgery, the alveolar cleft, preprosthetic surgery and major jaw reconstruction. Several studies reported a complication rate of 1-4% 3,7,11,12,14,16,20,22 from harvesting proximal tibia, which is less than the iliac bone harvesting rate. Proximal tibia harvesting also requires less operating time, is easy to perform 16 and has less gait disturbance when compared to iliac bone harvesting 10 .…”

Tibial bone fractures occurring after medioproximal tibial bone grafts for oral and maxillofacial reconstruction

“…One study5 about tibial grafts reported complications including swelling, gait disturbance for 3-4 weeks, and dehiscence of suture site. Likewise, Lezacano et al11 explained that articular surface damage, tendon or nerve damage, and rare tibial fracture as potential complications.…”

“…The conventional surgical procedure for medio-proximal tibial graft is performed through a vertical or oblique incision at the medial portion of the tibial tuberosity2,8,9,11. In contrast, we created a horizontal incision in the wrinkle line just below the tibial tuberosity in order to reduce scar formation5,6.…”