[Harvesting cancellous bone or composite corticocancellous bone grafts from the posterior iliac crest]
Steffi S I Falk1, Thomas Mittlmeier2
1Klinik für Unfall‑, Hand- & Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland. Steffi.falk@med.uni-rostock.de.
Objective:
Harvesting bone-either cancellous bone or composite corticocancellous bone grafts-from the iliac crest is an efficient method for filling or bridging bony defects commonly encountered in comminuted epimetaphyseal fractures (e.g., tibial head fractures), in nonunions or during reconstructive measures as in arthrodesis of major joints or spondylodesis, bone defects due to tumor resection or following eradication of chronic infection.
Indications:
All bone defects with a maximum size of 4-5 cm.
Contraindications:
Rejection of surgery by the patient, infection or evidence of pathological bony changes in the posterior pelvic rim, inexperience of the surgeon with the procedure.
Surgical Technique:
Incision at the posterior iliac crest and removal of a structural or cancellous bone graft of predetermined length. Depending on the bleeding tendency, a suction drain can be inserted.
Postoperative Management:
After surgery supine positioning is favorable for wound compression to avoid bleeding as well as sufficient analgesia. Mobilization is dictated by the main operation. The pelvis is not compromised in its mechanical integrity and allows for full weight bearing on the operated side.
