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Use of Human Perivascular Stem Cells for Bone Regeneration
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[Technical note: iliac crest bone graft harvesting in children]
B Bertrand1, C Philandrianos1, N Apostolou2
1Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France.
Insights
Harvesting iliac crest bone in pediatric patients requires special techniques due to thick cartilage. Surgeons must carefully preserve the lateral femoral cutaneous nerve during this bone graft procedure.
Area of Science:
- Orthopedic Surgery
- Pediatric Bone Grafting
- Surgical Anatomy
Context:
- Pediatric iliac crest bone harvesting presents unique anatomical challenges.
- The presence of thick cartilage necessitates modified surgical approaches.
- Protecting the lateral femoral cutaneous nerve is critical during the procedure.
Purpose:
- To describe a specialized technique for pediatric iliac crest bone harvesting.
- To highlight the anatomical considerations and critical steps for successful bone grafting in children.
- To emphasize the importance of preserving the lateral femoral cutaneous nerve.
Summary:
- The technique involves applying pressure to the iliac fossa to mobilize skin and abdominal muscles.
- A single incision allows for dissection, removal of cartilage, and retraction of iliac muscle.
- Cortical and spongy bone are harvested from the internal iliac crest, with cartilage being resutured.
- Careful attention is paid to preserving the lateral femoral cutaneous nerve throughout the procedure.
Impact:
- Provides a detailed surgical method for pediatric bone harvesting.
- Aims to improve surgical outcomes and minimize complications in pediatric patients.
- Contributes to the understanding of specialized orthopedic procedures in pediatric surgery.
Abstract:
Harvesting iliac crest bone in children is special because of the presence of a thick cartilage. Constant pressure on the internal iliac fossa, ascends the skin, and moves the abdominal muscles away from the iliac crest. A single incision is then used for cutaneous and subcutaneous dissection. An internal piece of cartilage is then removed and the iliac muscle retracted in order to harvest cortical and spongy bone from the internal side of the iliac crest. That pièce of cartilage is then sutured at its initial place. During the harvesting, the surgeon needs to be careful to preserve the lateral femoral cutaneous nerve.
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