Morbidity from anterior ilium bone harvest. A comparative study of lateral versus medial surgical approach

The morbidity of bone harvest was compared between anterior lateral and medial surgical approaches in a randomized prospective study. Forty consecutive patients, each requiring a minimum 40 cc of loose corticocancellous bone for maxillofacial reconstruction, were randomly placed into two equal groups. Morbidity vectors assessed included bone volume, blood loss, length of surgery, length of hospital stay, incidence of seroma, incidence of anterior thigh paresthesia, postoperative pain, and gait disturbance. The results demonstrated no significant difference in morbidity between these two approaches; therefore selection of either approach is the surgeon's personal preference. A thorough understanding of the osseous anatomy of the anterior ilium and its muscular attachments, a good surgical technique, an efficient surgical team, and a continuous flow of required surgical instruments are essential to reduce the morbidity of bone harvest.