自体植骨髂嵴前部取骨的几种方式比较

Comparative analysis of different methods of anterior iliac crest harvesting in autologous bone graft

目的探讨自体植骨时不同用途自髂嵴前部取骨的方式。方法对2003年1月～2010年12月我科住院应用自体髂骨植骨患者625例,分别采用髂骨三皮质取骨、单皮质髂骨板、环钻骨柱取骨、合页式开窗取骨、髂骨骺下开窗取骨5种取骨方式,比较各种方式的并发症情况。结果 603例患者得到随访,随访时间6月～6年,平均12.5月,所发生并发症依次为供骨区疼痛、神经损伤、切口愈合不良、血肿、感染,总发生率为14.9%。环钻骨柱取骨法并发症发生率最小,为7.4%。结论髂骨取骨方式应根据需要合理采用,可以避免浪费骨源,减少并发症发生。

Objective To summarize different ways of anterior iliac crest harvesting in autologous bone graft. Methods Clinical data of 625 cases of patients who received grafting procedures of harvesting iliac bone from January 2003 to December 2010 were analyzed. The cases were classified into different types of harvesting such as tricortical iliac bone, internal or exter- nal cortical iliac bone,lilac bone cage by circle saw, open window on iliac crest and open window under iliac epiphyseal. The complications of the 5 types were compared. Results 603 cases were followed-up for an average of 12.5 months （ range, 6 months-6 years}. The occurrence rate of complication was 14.9%. The top five leading complications were chronic pain at iliac donor sites, nervous injury, infection, hematoneus and poor postoperative incision healing. Only 7.4% of complication occurred in iliac bone cage by circle saw type, which was the lowest. Conclusion A reasonable iliac harvesting method should be cho- sen for bone graft. It can reduce complications and save bone sources.