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Comparison of the inner side and two-sided approaches for iliac crest bone graft harvesting for pediatric pelvic
Xin Chen1, Kai Chen2, Yuxi Su3
1Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Insights
Harvesting iliac crest bone grafts from the inner side only promotes faster bone defect recovery in children compared to two-sided approaches. Protecting the outer ilium during surgery is recommended for improved outcomes.
Area of Science:
- Orthopedic surgery
- Pediatric bone grafting
Background:
- The iliac crest is a common source for bone grafts in pediatric orthopedic procedures.
- Surgical approaches for iliac crest bone harvesting can impact post-operative ilium growth.
Purpose of the Study:
- To evaluate the effects of inner-side versus two-sided iliac crest bone harvesting on post-operative ilium growth in children.
- To compare complication rates between different surgical approaches.
Main Methods:
- Retrospective analysis of 47 pediatric patients undergoing pelvic osteotomy and iliac crest bone graft (ICBG).
- Patients divided into inner table exposure (Group A) and inner-outer table exposure (Group B).
- Radiographic follow-up at 1, 3, 6, and 12 months post-surgery with growth area measurements.
Main Results:
- No significant demographic or early growth differences between groups.
- Significantly better bone graft growth at 3, 6, and 12 months in the inner-side exposure group (Group A).
- No significant difference in complication rates between the two groups.
Conclusions:
- Exposure of only the inner table of the ilium leads to faster bone defect recovery after pelvic osteotomy.
- Protecting the outer ilium during surgery is suggested to optimize bone graft healing in pediatric patients.
Background:
The iliac crest is one of the most used bone graft sources. In this study, we aimed to identify the effects of inner side and two-sided approaches for iliac crest bone harvesting on post-surgery ilium growth in children.
Materials And Methods:
We retrospectively analyzed 47 patients who underwent pelvic osteotomy and iliac crest bone graft (ICBG) procedures from January 2015 to September 2018. The patients were divided into an inner table ilium exposure group (group A) and the inner-outer table ilium exposure group (group B) and were followed up with radiography in postoperative months 1, 3, 6, and 12, and the growth areas were measured using PACS software. Complications such as damage to the arteries or nerves, ureteral injury, gastrointestinal hernia, ileus, abnormal cosmetic appearance, sensory disturbances, and functional limitations were recorded based on clinical records.
Results:
There were 22 patients aged 5.3±1.5 years in group A and 25 patients aged 5.9±1.8 years in group B. There were no significant differences in demographics between the two groups, or in growth in the first month. However, bone graft growth at months 3, 6, and 12 was significantly better in group A than in group B. There was no significant difference in complications between the two groups.
Conclusion:
Exposure of only the inner table of the ilium resulted in faster recovery of the bone defect than two-sided exposure in pelvic osteotomy. Therefore, we suggest protecting the outer side of the ilium during surgery.
Level Of Evidence:
Level III.
