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Ghép xương chậu

Xương hông và xương mác là các trang web phổ biến nhất cho thu hoạch ghép xương. Các phương pháp khác nhau để thu hoạch ghép xương chậu bao gồm cửa sập, nạo buồng tử cung hoặc các kỹ thuật tách xương cancellous, và kỹ thuật subcrestal cửa sổ ghép bicortica | Bone-Graft Harvesting From Iliac and Fibular Donor Sites Techniques and Complications Nabil A. Ebraheim MD Hossein Elgafy MD and Rongming Xu MD Abstract The ilium and the fibula are the most common sites for bone-graft harvesting. The different methods for harvesting iliac bone graft include curettage trapdoor or splitting techniques for cancellous bone and the subcrestal-window technique for bicortical graft. A tricortical graft from the anterior ilium should be taken at least 3 cm posterior to the anterior superior iliac spine ASIS . Iliac donor-site complications include pain neurovascular injury avulsion fractures of the ASIS hematoma infection herniation of abdominal contents gait disturbance cosmetic deformity violation of the sacroiliac joint and ureteral injury. The neurovascular structures at risk for injury during iliac bone-graft harvesting include the lateral femoral cutaneous iliohypogastric and ilioinguinal nerves anteriorly and the superior cluneal nerves and superior gluteal neurovascular bundle posteriorly. Violation of the sacroiliac joint can be avoided by limiting the harvested area to 4 cm from the posterior superior iliac spine PSIS and by not penetrating the inner cortex. The caudal limit for bone harvesting should be the inferior margin of the roughened area anterior to the PSIS on the outer table to keep from injuring the superior gluteal artery. Potential complications of fibular graft harvesting include neurovascular injury compartment syndrome extensor hallucis longus weakness and ankle instability. The neurovascular structures at risk for injury during fibular bone-graft harvesting include the peroneal nerves and their muscular branches in the proximal third of the fibular shaft and the peroneal vessels in the middle third. J Am Acad Orthop Surg 2001 9 210-218 standing of the anatomy of the donor sites the surgical techniques and the potential complications of harvesting bone grafts from the ilium and fibula is important to minimize .