Therapeutics and Clinical Risk Management (Jun 2020)
Iliac Bone Harvesting Techniques for Bone Reconstruction. Comparative Study Between Tricortical Bone Harvesting vs Trapdoor Technique
Abstract
Jia-Fu Zhu,1 Wei-Xing Xu,1 Qiang Hu,1 Tian-Quan Wu,2 Hong Liu1 1Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, People’s Republic of China; 2Department of Orthopaedics, Shaoxing Keqiao District Hospital of Traditional Chinese Medicine, Shaoxing 312030, People’s Republic of ChinaCorrespondence: Wei-Xing XuDepartment of Orthopaedics, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, People’s Republic of ChinaTel +86-13750837328Email [email protected]: To investigate the effects of trapdoor-procedure-based bone harvesting and tricortical iliac bone harvesting on the iliac bone-graft donor site pain experienced by patients and their clinical effects.Methods: A retrospective analysis was performed using the clinical data of 65 patients with tibial plateau fractures who received autologous iliac bone-supporting grafts in two hospitals between January 2014 and January 2019. The patients who received trapdoor-procedure-based bone harvesting (34 cases) were in the experimental group, and those who received tricortical iliac bone harvesting (31 cases) were in the control group. This study compared differences in iliac bone-graft donor site incision length, intraoperative blood loss, amount of bones harvested, operation time, and postoperative complications between the two bone-harvesting methods. Subsequently, it evaluated the pain experienced by the two patient groups in their iliac bone-graft donor sites and their clinical effects.Results: One week after surgery, the differences between the iliac bone-graft donor site pain score (measured using SF-MPQ-2) of the experimental group and the control group were not statistically different. However, 3 weeks, 5 weeks, and 3 months after surgery, the iliac bone-graft donor site pain scores of the experimental group were significantly lower than those of the control group. The iliac bone-graft donor site incision length and operation time of the experimental group were not significantly different from those of the control group. However, the iliac bone-graft donor site intraoperative blood loss, amount of bones harvested and the incidence of complications of the experimental group were significantly lower than those of the control group.Conclusion: Trapdoor-procedure-based bone harvesting has lower donor site pain, intraoperative blood loss, and postoperative complications. However, for bone grafting in regions with significant bone loss, tricortical iliac bone harvesting remains the optimal option.Keywords: iliac bone, bone grafting, pain, clinical effect
