Jw. Canady et al., SUITABILITY OF THE ILIAC CREST AS A SITE FOR HARVEST OF AUTOGENOUS BONE-GRAFTS, The Cleft palate-craniofacial journal, 30(6), 1993, pp. 579-581
Many donor sites have been advocated for obtaining cancellous bone to
be used for grafting alveolar defects. Recently, some authors have sug
gested that the iliac crest site produced an unacceptably high degree
of postoperative morbidity. Because of this morbidity, the use of othe
r donor areas, e.g., rib, cranium, and mandible, are advocated. The il
iac crest donor site for alveolar bone grafting has been common practi
ce in our institution for years under the assumption that little or no
postoperative morbidity occurred. To investigate and document the acc
uracy of our assumption, the charts of the most recent 50 consecutive
patients receiving alveolar bone grafts, all of which used the iliac c
rest as a donor site, were reviewed. Postoperative pain, numbness, inf
ection, paralysis, or long-term disability were catalogued from the ch
arts. In addition, a questionnaire was sent to the parents and patient
s requesting their perceptions of these parameters. In the cases revie
wed, the average length of skin incision was 4.2 cm. The average quant
ity of bone harvested was 4.1 cc. The usual hospitalization time was 2
-3 days. No patients experienced serious or long-term complications at
the surgical donor site. Immediate postoperative complications among
the 50 patients studied were limited to one hematoma, one stitch absce
ss, one case of swelling with pain, one erythema, and one 4-day fever
accompanied by slight serosanguineous drainage. Information from the q
uestionnaire suggests that most patients returned to full activity wit
hin 4-6 weeks. No patient reported any long-term pain or disability. W
e conclude that the iliac crest is a suitable site to harvest cancello
us bone for use in alveolar defect grafting, and should not be rejecte
d solely because of concerns regarding excessive morbidity.