치조열 교정을 위한 장골 능선 해면골 재이식술 (The Reharvesting of Iliac Crest Cancellous Bone for the Repair of the Alveolar Cleft)

서지정보

· 발행기관 : 대한성형외과학회
· 수록지 정보 : Archives of Plastic Surgery / 38권 / 1호 / 15 ~ 18페이지
· 저자명 : 김석화, 김병준, 최태현

초록

Purpose: The anterior iliac crest is a common source for autologous cancellous bone graft. For patients who have previously received cancellous bone grafts from bilateral anterior iliac crests, there may be concerns of whether a sufficient quantity of autologous cancellous bone remains for additional grafts without harvesting it from other sites, such as the posterior iliac crest.
Methods: We experienced 3 cases of reharvesting in 2 patients. The diagnosis of the first patient was bilateral facial cleft number3. This patient received bilateral side cleft alveoloplasty with corticocancellous bone graft from the both anterior iliac crest respectively by a previous surgeon. This patient then needed to reharvest the anterior iliac crest cancellous bone to correct an ongoing skeletal problem for the bilateral cleft.
The other patient had bilateral incomplete cleft of the primary palate. This patient received left side cleft alveoloplasty with cancellous bone graft from the right anterior iliac crest. Before the patient could receive the alveoloplasty on the other side, a radial head osteotomy and cancellous bone graft was performed by orthopedic surgeons who then used the remaining left iliac crest in order to treat a pulled elbow. For the completion of the right side cleft alveoplasty, the anterior iliac crest cancellous bone needed to be reharvested. Prior to the reharvesting, a preoperative computed tomography scan of the pelvis was obtained to assess the maturity of the donor site regeneration. The grafts were then taken from sites where a greater amount of regeneration was evident.
Results: Long term follow ups showed that the grafts were successfully taken. This sufficient volume was obtainable 14 months after the first harvest.
Conclusion: Satisfactory results were achieved after the reharvesting of iliac cancellous bone. Thus, it appears that the reharvesting of the iliac bone is a possible alternative to multiple site grafting, use of allograft or bone substitute materials.

영어초록

Purpose: The anterior iliac crest is a common source for autologous cancellous bone graft. For patients who have previously received cancellous bone grafts from bilateral anterior iliac crests, there may be concerns of whether a sufficient quantity of autologous cancellous bone remains for additional grafts without harvesting it from other sites, such as the posterior iliac crest.
Methods: We experienced 3 cases of reharvesting in 2 patients. The diagnosis of the first patient was bilateral facial cleft number3. This patient received bilateral side cleft alveoloplasty with corticocancellous bone graft from the both anterior iliac crest respectively by a previous surgeon. This patient then needed to reharvest the anterior iliac crest cancellous bone to correct an ongoing skeletal problem for the bilateral cleft.
The other patient had bilateral incomplete cleft of the primary palate. This patient received left side cleft alveoloplasty with cancellous bone graft from the right anterior iliac crest. Before the patient could receive the alveoloplasty on the other side, a radial head osteotomy and cancellous bone graft was performed by orthopedic surgeons who then used the remaining left iliac crest in order to treat a pulled elbow. For the completion of the right side cleft alveoplasty, the anterior iliac crest cancellous bone needed to be reharvested. Prior to the reharvesting, a preoperative computed tomography scan of the pelvis was obtained to assess the maturity of the donor site regeneration. The grafts were then taken from sites where a greater amount of regeneration was evident.
Results: Long term follow ups showed that the grafts were successfully taken. This sufficient volume was obtainable 14 months after the first harvest.
Conclusion: Satisfactory results were achieved after the reharvesting of iliac cancellous bone. Thus, it appears that the reharvesting of the iliac bone is a possible alternative to multiple site grafting, use of allograft or bone substitute materials.

참고자료

· 없음