Anterior iliac crest bone graft. Anatomic considerations.
ABSTRACT A morphologic study of the anterior part of the iliac crest was performed.
To define the anatomic characteristics of the anterior part of the ilium and to determine an optimal area to harvest the iliac bone graft from the anterior iliac crest.
Stress fracture or avulsion fracture of the anterior cut for anterior iliac crest graft have been noted previously. However, there is insufficient published information on the morphology of the anterior part of the ilium relative to the optimal location of harvesting the bone graft.
Direct measurements using digital calipers were taken from 30 dried human pelves and 10 cadaveric pelves. The thickness of the anterior part of the ilium was measured, with different starting points on the iliac crest. The length of the bicortical iliac bone graft also was determined.
The thickest portion of the ilium was 18.9 +/- 2.3 mm at the iliac tubercle, which was 45% thicker than at a point 3 cm posterior to the anterior superior iliac spine. The thick region of the anterior iliac crest extended 54.0 +/- 10.2 mm posteriorly from a point 3 cm posterior to the anterior superior iliac spine. The mean length of a 10 mm thick bicortical iliac tubercle bone graft was 36.8 +/- 8.7 mm.
The region around the iliac tubercle is suitable for harvesting bicortical or tricortical bone graft.
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Chapter: Basic Knowledge of Bone Grafting03/2012; , ISBN: 978-953-51-0324-0
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ABSTRACT: We assessed the morphological characteristics and dimensions of the ilium and fibula to evaluate the suitability of particular areas of bone for use as donor sites for dental reconstructions that carry implants. We measured the dimensions of 130 bilaterally harvested ilium and fibula bones from 65 adult cadavers using osteometric methods, and analysed the effects of age, sex, and side. Dimensions at measuring points, overall suitability for implantation, and relations among age, sex, and side, were evaluated statistically. We report observations of bone morphology involving cross-sections, and clinical relevance. Although the mean dimensions of the fibula and iliac crest were adequate, some segments would not support an implant 10mm long and 3.5mm wide. The overall suitability of parts of the iliac block fell to 30%. Fibular morphology is characterised by constant height and width, and relation of cortical and cancellous bone. Bony dimensions on the iliac fossa and fibula were significantly greater in men than in women. Age had a negative impact in one area of the iliac fossa, but nowhere on the iliac crest. Side was not significant. We found differences in dimensions and morphology between measuring points on the same bone. Precise knowledge about which areas of the donor sites can reliably provide sufficient bone to carry implants after reconstructions will allow greater flexibility and safety when reconstructions are designed.British Journal of Oral and Maxillofacial Surgery 08/2013; · 2.72 Impact Factor
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ABSTRACT: Anterior iliac crest bone is a widely used donor site for bone harvesting. It provides an autologous bone graft consisting of cancellous bone that can be packed or cortical bone with greater structural support. Uses include spinal fusion and fracture non-union surgery. Although its use is common, dedicated anatomical and radiological studies analysing graft dimensions and optimal harvesting site in relation to local anatomical landmarks [anterior superior iliac spine (ASIS), anterior iliac tubercle (AIT) and lateral femoral cutaneous nerve (LFCN)] have not been described. Twenty-eight female hemipelvises were dissected for this study. The LFCN, ASIS and AIT were identified. Calliper measurements and CT scan analysis were undertaken to determine the optimum positions in obtaining a 5-mm-thickness tricortical graft whilst remaining safe for the LFCN. According to our measurements, the optimal location for harvesting a 5-mm-thick tricortical graft with 35-mm height and 47-mm width is situated anterior to a line passing at the level of the thickest point of the AIT. This thickest point was situated at a mean 67 mm from the centre of the EIAS in our study. This anatomical and radiographic study determined the anatomical iliac crest landmarks to avoid neurological injury when taking an optimal 5-mm-width tricortical bone graft.European Spine Journal 12/2013; · 2.13 Impact Factor