[Complications after harvesting of autologous bone from the ventral and dorsal iliac crest - a prospective, controlled study]

Abstract

Introduction: In a prospective, controlled study, donor site morbidity after bone graft harvesting from the anterior and posterior iliac crest was documented.

Methods: In 113 patients, monocortical to tricortical bone grafts were taken from the anterior (n = 73) or dorsal (n = 40) iliac crest. Bone graft size (0.4 - 43 cm 3, median 9.7 cm 3), Operation time (12 - 65 minutes, median 28 minutes), and postoperative donor site were documented.

Results: Donor site morbidity was higher after harvesting from the ventral than from the dorsal iliac crest: total morbidity 48 vs. 32.5 %, large haematomas 9.6 vs. 7.5 %, moderate haematomas 34.3 vs. 15 %, wound dehiscence 2.7 vs. 0 %. One revision operation was necessary because of a large haematoma at the ventral crest. After harvesting from the ventral iliac crest, there was one fracture ofthe iliac wing and one avulsion fracture of the iliac crest. There were no infections, no injuries of arteries or of the lateral femoral cutaneous nerve and no hemiation. After harvesting from the dorsal iliac crest, there were no major complications.

Conclusion: Bone graft harvesting from the posterior iliac crest should be preferred over harvesting from the anterior iliac crest beeause of the substantially reduced donor site morbidity. Harvesting from the ventral iliac crest should have a clear indication, synthetic bone substitutes should be taken into consideration.