Anatomical reconstruction of donor site after large iliac crest graft harvest with equivalent iliac crest allograft. A prospective controlled study

Y.-f. Niu, X.-f. AN, D.-j. Wu, S.-g. Xu, C.-c. Zhang, M. Li

Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai, China. minglichuncaizhang@gmail.com

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• Orthopedics

BACKGROUND: Iliac bone graft harvesting is a common procedure in spinal surgery and trauma center for spinal fusion and nonunion of the extremities.

AIM, PATIENTS AND METHODS: To compare the pain and cosmetic outcomes of patients undergoing iliac crest anatomical reconstruction using equivalent iliac crest allograft (R group) with those of patients without reconstruction of the iliac crest defect (NR group), a prospective nonrandomized controlled study was conducted.

RESULTS: In R group, the intensity and prevalence of pain were significantly lower than those in NR group. Cosmetic outcome and satisfaction score were also significantly improved in R group. One patient of R group suffered from lipolysis and superficial infection which healed by regular dressing change for two weeks. There were no cases of allograft displacement, implant loosening, internal fixation breakage or immunological rejection. Seven patients in NR group had significant pain related to the tenting of skin over the defect. Radiologic incorporation of pelvis was documented in all patients except four having partial re-sorption of the allograft. Early fibrous healing and the late creeping substitution were noted in all patients of R group.

CONCLUSIONS: Equivalent iliac crest allograft provides an effective alternative for iliac crest anatomical reconstruction, leading to reduced donor site pain and better cosmesis.

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