03529nas a2200421   4500008004100000022002200041245012400063210006900187250001000256260000800266300001300274490000900287520222500296653003802521653003302559653001502592653001002607653000902617653004402626653001002670653001102680653001102691653004802702653000902750653001602759653004802775653002102823653002502844653003902869653002602908653005102934100001502985700001603000700001403016700001603030700001403046856004703060       2002                        eng d  a0021-9355 (Print)00aComparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes0 aComparison of anterior and posterior iliac crest bone grafts in   a37387  cMay  a716 - 200 v84-A3 aBACKGROUND: Previous studies have demonstrated high complication rates after harvest of iliac crest bone grafts. This study was undertaken to compare the morbidity related to the harvest of anterior iliac crest bone graft with that related to the harvest of posterior iliac crest bone graft and to determine differences in functional outcome. METHODS: The medical records of eighty-eight consecutive patients who had undergone a total of 108 iliac crest bone-grafting procedures for the treatment of chronic osteomyelitis from 1991 to 1998 were retrospectively reviewed. Demographic characteristics, the location of the harvest, the volume of bone graft that was harvested, the estimated blood loss, and postoperative complications were recorded. Fifty-eight patients completed a questionnaire pertaining to postoperative and residual pain, sensory disturbances, functional limitations, cosmetic appearance, and overall satisfaction with the bone-graft harvesting procedure. RESULTS: Sixty-six anterior and forty-two posterior bone-graft harvest sites were evaluated at a minimum of two years after the operation. A major complication was associated with 8% (five) of the sixty-six anterior sites and 2% (one) of the forty-two posterior sites. The rates of minor complications were 15% (ten) and 0%, respectively. In the series as a whole, there were ten minor complications (9%) and six major complications (6%). The rates of both minor complications (p = 0.006) and all complications (p = 0.004) were significantly higher after the anterior harvest procedures than they were after the posterior procedures. The postoperative pain at the donor site was significantly more severe (p = 0.0016) and of significantly greater duration (p = 0.0017) after the anterior harvests. No patient reported functional limitations at the latest follow-up evaluation. CONCLUSIONS: In this series, the complication rate was lower than those previously reported by other investigators. Harvest of a posterior iliac crest bone graft was associated with a significantly lower risk of postoperative complications. On the basis of the results of this study, we recommend that iliac crest bone graft be harvested posteriorly whenever possible.10a*Outcome Assessment (Health Care)10a*Postoperative Complications10aAdolescent10aAdult10aAged10aBone Transplantation / *adverse effects10aChild10aFemale10aHumans10aIlium / *physiopathology / *transplantation10aMale10aMiddle Aged10aOsteomyelitis / *physiopathology / *surgery10aPain Measurement10aPatient Satisfaction10aRecovery of Function / *physiology10aRetrospective Studies10aTissue and Organ Harvesting / *adverse effects1 aAhlmann, E1 aPatzakis, M1 aRoidis, N1 aShepherd, L1 aHoltom, P  uhttps://www.notifylibrary.org/reference/39