Morbidity associated with anterior iliac crest harvesting for osseous reconstruction of alveolar clefts

Abstract

Introduction: The anterior iliac crest is considered the best site for harvesting autogenous bone graft for reconstruction of alveolar cleft since decades. As it is with the other sites of autogenous bone graft harvesting, anterior iliac crest also results in postoperative morbidity. The purpose of this study is to assess the associated postoperative morbidity with anterior iliac crest harvesting in the treatment of individual with alveolar clefts. Patients and Methods: A total of 92 patients with alveolar clefts were treated with autogenous bone grafting harvested from the anterior iliac crest in the duration from January 2009 to December 2014. Postoperatively, on day 1, day 7, 1st month, 3rd month, and 6th month, morbidity was assessed in these patients with postoperative pain, gait disturbance, sensory disturbance, and scarring being the parameters of assessment. Results: Postoperative pain was a complaint of all the patients on day 1 which reduced to 3.26% of patients on day 7 and after 1 month revealed no patients was experiencing pain. On day 1, 69.57% of patients and 97.83% of patients complained of sensory and gait disturbances, respectively. These numbers decreased to 6.52% and 8.7%, respectively, on day 7th, further decreasing to 2.17% and 1.09%, respectively, after 1 month. None of the patients had gait and sensory disturbances after 3 months. On scar evaluation, only one patient had a hypertrophic scar at the end of 6 months postoperatively. None of the parameters were statistically significant on completion of the 1st, 3rd, and 6th month. Conclusion: Anterior iliac crest can still be continued to be considered a first option for harvesting autogenous bone graft for rehabilitation of patients with alveolar clefts as it is well tolerated by them. It has low morbidity which allows early resumption of normal activities and has a reasonable esthetic outcome.

Keywords

• alveolar cleft
• anterior iliac crest
• gait disturbance
• postoperative morbidity
• postoperative pain
• postoperative scarring
• sensory disturbance