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Archives of Orthopaedic and Trauma Surgery

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01-03-2019 | Handsurgery

Donor site complications following anterior iliac crest bone graft for treatment of distal radius fractures

Authors: Arnold J. Suda, Christian T. Schamberger, Tim Viergutz

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2019

Abstract

Introduction

In distal radius fractures with metaphyseal comminution, bone grafting or the use of a bone substitute may be necessary. Harvesting autologous iliac crest bone graft for other orthopedic procedures has complications. The aim of this study was to evaluate the complication rate after harvesting a small amount of bone as used for the treatment of radius fractures.

Patients and methods

Patients treated in a single level I trauma center with surgical treatment for distal radius fracture with iliac crest bone graft between January 2008 and December 2012 were included in this retrospective study. Patients’ records were evaluated and clinical evaluation was performed at follow-up.

Results

42 patients (20 females, 22 males, mean age 56.3 ± 15.9 years) were included in this study. Follow-up was mean 6.3 ± 1.2 years. Only minor complications such as hematoma could be identified; in one patient, revision surgery for bleeding was performed. No nerve injuries, long-term pain, fractures, infections or wound healing disturbances could be seen. The use of a drain of hemostyptics, the type of wound closure or pattern of harvested bone did not influence complication rate.

Conclusion

This study shows that harvesting a small amount of iliac crest bone graft for the treatment of distal radius fractures is a safe procedure with a very low complication rate.

Ahlmann E, Patzakis M, Roidis N, Shepherd L, Holtom P (2002) Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Jt Surg Am 84-A(5):716–720CrossRef

Armaghani SJ, Even JL, Zern EK, Braly BA, Kang JD, Devin CJ (2016) The evaluation of donor site pain after harvest of tricortical anterior iliac crest bone graft for spinal surgery: a prospective study. Spine (Phila Pa 1976) 41(4):E191–E196CrossRef

Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA (1996) Complications of iliac crest bone graft harvesting. Clin Orthop Relat Res 329:300–309CrossRef

Barone A, Ricci M, Mangano F, Covani U (2011) Morbidity associated with iliac crest harvesting in the treatment of maxillary and mandibular atrophies: a 10-year analysis. J Oral Maxillofac Surg 69(9):2298–2304CrossRefPubMed

Barth A (1893) Ueber histologische Befunde nach Knochenimplantationen. Arch Klin Chir 46:409–417

Baschkirzew NJ, Petrow NN (1912) Beiträge zur freien Knochenüberpflanzung. Deutsche Zeitschrift für Chirurgie 113:490–531CrossRef

Calori GM, Colombo M, Mazza EL, Mazzola S, Malagoli E, Mineo GV (2014) Incidence of donor site morbidity following harvesting from iliac crest or RIA graft. Injury 45(Suppl 6):S116–S120CrossRef

Cummings SR, Black DM, Rubin SM (1989) Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 149(11):2445–2448CrossRef

Dimitriou R, Mataliotakis GI, Angoules AG, Kanakaris NK, Giannoudis PV (2011) Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review. Injury 42(Suppl 2):S3–S15CrossRef

10.

Diwersi N, Babst R, Link BC (2016) Miniplates as augmentation implants in osteosynthesis of complex distal radial fractures. Oper Orthop Traumatol 28(5):402–406CrossRefPubMed

11.

Egol KA, Nauth A, Lee M, Pape HC, Watson JT, Borrelli J Jr (2015) Bone grafting: sourcing, timing, strategies, and alternatives. J Orthop Trauma 29(Suppl 12):S10–S14CrossRefPubMed

12.

Erhart S, Toth S, Kaiser P, Kastenberger T, Deml C, Arora R (2018) Comparison of volarly and dorsally displaced distal radius fracture treated by volar locking plate fixation. Arch Orthop Trauma Surg 138(6):879–885CrossRefPubMed

13.

Fasolis M, Boffano P, Ramieri G (2012) Morbidity associated with anterior iliac crest bone graft. Oral Surg Oral Med Oral Pathol Oral Radiol 114(5):586–591CrossRefPubMed

14.

Fernandez DL (2000) Should anatomic reduction be pursued in distal radial fractures? J Hand Surg Br 25(6):523–527CrossRefPubMed

15.

Haeseker B (1991) Van Meekeren and his account of the transplant of bone from a dog into the skull of a soldier. Plast Reconstr Surg 88(1):173–174CrossRefPubMed

16.

Heary RF, Schlenk RP, Sacchieri TA, Barone D, Brotea C (2002) Persistent iliac crest donor site pain: independent outcome assessment. Neurosurgery 50(3):510–516; (discussion 516–517)PubMed

17.

Heiß C, Maier GS, Gelinsky M, Hose D, Schnettler R (2013) Klinische Verwendung osteologischer Biomaterialien. Osteologie 22(3):172–178

18.

Heneghan HM, McCabe JP (2009) Use of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis. BMC Musculoskelet Disord 10:158CrossRefPubMedPubMedCentral

19.

Kessler P, Thorwarth M, Bloch-Birkholz A, Nkenke E, Neukam FW (2005) Harvesting of bone from the iliac crest–comparison of the anterior and posterior sites. Br J Oral Maxillofac Surg 43(1):51–56CrossRefPubMed

20.

Kitzinger HB, Karle B, Krimmer H, Prommersberger KJ, van Schoonhoven J, Frey M (2013) Prospective study on harvesting autologous bone grafts from the anterior iliac crest using a new specialized reamer. Ann Plast Surg 71(5):566–570CrossRefPubMed

21.

Kuner EH, Mellios K, Berwarth H (2002) Behandlung der komplizierten distalen Radiusfraktur mit dem Fixateur externe. Unfallchirurg 105:199–207CrossRefPubMed

22.

Kurien T, Pearson RG, Scammell BE (2013) Bone graft substitutes currently available in orthopaedic practice: the evidence for their use. Bone Jt J, 95-B(5):583–597CrossRef

23.

Lameijer CM, Ten Duis HJ, Dusseldorp IV, Dijkstra PU, van der Sluis CK (2017) Prevalence of posttraumatic arthritis and the association with outcome measures following distal radius fractures in non-osteoporotic patients: a systematic review. Arch Orthop Trauma Surg 137(11):1499–1513CrossRefPubMedPubMedCentral

24.

Loeffler BJ, Kellam JF, Sims SH, Bosse MJ (2012) Prospective observational study of donor-site morbidity following anterior iliac crest bone-grafting in orthopaedic trauma reconstruction patients. J Bone Jt Surg Am 94(18):1649–1654CrossRef

25.

Lutz M, Erhart S, Deml C, Klestil T (2016) Arthroscopically assisted osteosynthesis of intraarticular distal radius fractures. Oper Orthop Traumatol 28(4):279–290CrossRefPubMed

26.

Mowlem A (1945) Cancellous chip grafts for the restoration of bone defects. Proc R Soc Med, 38(4):171–174PubMedPubMedCentral

27.

Müller M, Koch P, Nazarian S, Schatzker J (1990) The comprehensive classification of fractures of long bones. Springer, BerlinCrossRef

28.

Raposo-Amaral CA, Denadai R, Chammas DZ et al (2015) Cleft patient-reported postoperative donor site pain following alveolar autologous iliac crest bone grafting: comparing two minimally invasive harvesting techniques. J Craniofac Surg 26(7):2099–2103CrossRefPubMed

29.

Sasso RC, LeHuec JC, Shaffrey C, Spine Interbody Research G (2005) Iliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment. J Spinal Disord Tech 18(Suppl):S77–S81CrossRefPubMed

30.

Schaaf H, Lendeckel S, Howaldt HP, Streckbein P (2010) Donor site morbidity after bone harvesting from the anterior iliac crest. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(1):52–58CrossRefPubMed

31.

Schieker M, Heiss C, Mutschler W (2008) Knochenersatzmaterialien Der Unfallchirurg 111(8):613ffCrossRef

32.

Sheehan J (1941) The use of iliac bone in facial and cranial repair. Am J Surg 52(1):55–61CrossRef

33.

Shin SR, Tornetta P (2016) Donor site morbidity after anterior iliac bone graft harvesting. J Orthop Trauma 30(6):340–343CrossRefPubMed

34.

Stam LH, Kesselring AG, Promes P, van der Wal KG, Koudstaal MJ (2014) Morbidity of harvesting the iliac crest inner cortical plate for orbital reconstruction. J Oral Maxillofac Surg 72(7):1339–1342CrossRefPubMed

35.

Tjardes T, Otchwemah R, Hausmann D et al (2012) Rekonstruktion segmentaler Knochendefekte Stellenwert der Spongiosaplastik. Trauma Berufskrankh 14:77–82CrossRef

36.

Unglaub F, Langer MF, Hohendorff B et al (2017) Distal radius fracture of the adult: diagnostics and therapy. Der Orthopade 46(1):93–110CrossRefPubMed

37.

Vura N, Reddy KR, G RS, Kaluvala R VR (2013) Donor site evaluation: anterior iliac crest following secondary alveolar bone grafting. J Clin Diagn Res 7(11):2627–2630PubMedPubMedCentral

38.

Zenner J, Hitzl W, Mayer M, Koller H (2015) Analysis of postoperative pain at the anterior iliac crest harvest site: a prospective study of the intraoperative local administration of ropivacaine. Asian Spine J 9(1):39–46CrossRefPubMedPubMedCentral

Title: Donor site complications following anterior iliac crest bone graft for treatment of distal radius fractures
Authors: Arnold J. Suda
Christian T. Schamberger
Tim Viergutz
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-3098-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Donor site complications following anterior iliac crest bone graft for treatment of distal radius fractures

Abstract

Introduction

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusion

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