[Medial proximal tibia donor site: contribution to alveolar cleft repair in children]

Cancellous bone is the best material for alveolar cleft repair (or secondary alveolar cleft repair). It is usually harvested from the iliac bone but morbidity of this donor site is high. Among the other possible donor sites the tibial harvesting procedure seems safe with lower morbidity. The authors assessed the medio-proximal tibial harvesting procedure on a consecutive series of 55 children having undergone secondary alveoloplasty.

An individual questionnaire was used to assess retrospectively the intensity and duration of postoperative pain, functional impotence, possible late complications, and scar length. Postoperative tibial in frontal and profile radiographs were used to assess corticotomy diameter, the distance between corticotomy and growth plate, and local complications.

The mean patient age was nine years. No complications were reported. Sixty nine percent of patients complained of postoperative pain with an average intensity of four out of 10 for a period of 17 days. Sixty five percent of patients complained of discomfort in walking for an average of 12 days. The average scar length was 10 mm. Two patients (3.6%) presented with sequels two years after surgery, residual scar pain for one, and painless ectopic tibial ossification next to the sampling site for the other.

The medio-proximal tibial site bone harvesting morbidity is low. The surgical procedure is easy, rapid, and safe. The amount of cancellous bone collected is sufficient for two simultaneous alveolar defect grafts. This site seems especially well adapted for secondary alveoloplasty in children.