Iliac crest donor site morbidity following open and closed methods of boneharvest for alveolar cleft osteoplasty

Donor site morbidity after bone harvesting still remains a crucial problem in alveolar cleft osteoplasty. This study focuses on ilium donor site morbi dity comparing two different techniques. A series of 52 consecutive patient s was divided in half. All had anterior iliac crest bone grafts. In the stu dy group the harvesting was performed with a closed osteotomy using a cylin drical Shepard osteotome, The control group underwent the traditional open osteotomy, In the open osteotomy group the short-term morbidity at the donor site was slightly greater than in the closed harvesting group. The low short-term mo rbidity in the closed harvesting group was reflected in the analgesic consu mption which was three times higher in the open osteotomy group ( p < 0.008 ). The most striking difference occurred in the appearance of the mature sc ar: a length of 24.2 mm (mean) in the closed harvesting group against 60.3 mm in the open osteotomy group (p < 0.0001), and a width of 4.9 mm (mean) v ersus 7.7 mm, respectively (p < 0.003), The long-term morbidity was negligi ble in both groups. Based on these findings we suggest that bone harvesting from the anterior i liac crest remains the preferred method, provided that closed harvesting is undertaken. (C) 2000 European Association for Cranio-Maxillofacial Surgery .