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Bone grafting: An overview  [cached]
D. O. Joshi,P. H. Tank,H. K. Mahida,M. A. Dhami
Veterinary World , 2010,
Abstract: Bone grafting is the process by which bone is transferred from a source (donor) to site (recipient). Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of the surgeon. A search for ideal bone graft is on and may continue till time to time. [Vet World 2010; 3(4.000): 198-200]
A rare case of lumbar hernia following iliac crest bone graft  [cached]
Dilip Krishnarao Apturkar,Kundankumar Narayan Dandekar,Gokul Jaywant Jorwekar,Padmakar Kashinath Baviskar
International Journal of Biomedical and Advance Research , 2013, DOI: 10.7439/ijbar.v4i1.885
Abstract: Introduction: Harvesting bone graft from iliac crest is routine procedure in orthopaedics practice. Lumbar hernia following this procedure is rare. Lumbar hernia is classified as congenital, primary, post traumatic and incisional. Objective: Reporting herewith a case of right lumbar hernia in 58 years old female occurring 10 years following full thickness iliac crest bone graft. Conclusion: Iliac crest bone harvest needs to be performed meticulously to prevent postoperative hernia. If occurs, polypropylene mesh repair gives good results. Key Words: Lumbar hernia; iliac crest bone graft
Osteotomy and Autograft Lengthening for Intra-Articular Malunion of the Proximal Ulna: A Case Report
Job N. Doornberg,René K. Marti
Case Reports in Medicine , 2009, DOI: 10.1155/2009/647126
Abstract: An osteotomy with interposition of iliac crest bone graft and lengthening of the proximal ulna can be used to restore ulnohumeral congruency after a malunited comminuted olecranon fracture treated with figure-of-eight tension band wiring.
Mandibular defect reconstruction with nonvascularized iliac crest bone graft
VN Okoje, OS Obimakinde, JT Arotiba, AO Fasola, SO Ogunlade, AE Obiechina
Nigerian Journal of Clinical Practice , 2012,
Abstract: Context: Reconstruction of mandibular defect is a challenge to the head and neck surgeon because of associated functional and esthetic problems. Our experience with the use of nonvascularized iliac crest bone graft is hereby reported. Aim: The aim was to report our experience with the use of nonvascularized iliac crest bone for mandibular defect reconstruction at University College Hospital, Ibadan. Nigeria. Settings and Design: A retrospective descriptive study was performed. Materials and Methods: Cases of mandibular reconstruction with iliac crest bone graft between January 2001 and December 2007 were included in this study. Grafts were secured with either a stainless steel wire or a titanium plate. Preoperative diagnosis, postoperative follow-up records including investigations, diagnosis of graft infection and subsequent treatment modalities were extracted from the available records. Statistical analysis used: Descriptive variables were analyzed with SPSS version 14. Results: A total of 47 patients had mandibular defect reconstruction with nonvascularized iliac crest block bone during the study period. Thirty-eight patients had graft secured with transosseous wire [NVIBw] while 9 had a titanium plate [NVIBp]. The male:female ratio was 26:21 while the mean age of the patients was 24.6±4.25 years. Ten patients (21.3%) developed persistent graft infection during the postoperative period. All cases of infection occurred in patients who had transosseous wiring and analysis showed that 60% of the infected grafts revealed mixed microbial isolates containing klebsiela spp, pseudomonas aeurogenosa, and e coli. Six (60%) of the infected grafts were removed as a result of unabated infection while 4 (40%) were successfully treated by exploration and pus drainage. Conclusions: Nonvascularized iliac crest bone graft provides an affordable and less technical choice for mandibular reconstruction with minimal complications in a resource-limited economy.
Comparative study of technique to obtain stem cells from bone marrow collection between the iliac crest and the femoral epiphysis in rabbits
E?a, Lilian Pi?ero;Ramalho, Renata Belmonte;Oliveira, Isis Sousa;Gomes, Paulo Oliveira;Pontes, Paulo;Ferreira, Alice Teixeira;Mazzetti, Marcelo Paulo Vaccari;
Acta Cirurgica Brasileira , 2009, DOI: 10.1590/S0102-86502009000500011
Abstract: purpose: to assess the technique for the collection of rabbit bone marrow stem cells from different regions to be used as an experimental model in regenerative medicine. methods: thirty rabbits were allocated into 2 groups: group a, n=8, animals that underwent bone marrow blood (bmb) harvesting from the iliac crest; and group b: including 22 rabbits that underwent bmb harvesting from the femur epiphysis. after harvesting, mononuclear cells were isolated by density gradient centrifugation (ficoll - histopaque). the number of mononuclear cells per ml was counted in a neubauer chamber and cell viability was checked through tripan blue method. results: harvesting from the iliac crest yielded an average of 1 ml of bmb and 3,6.106 cells/ml over 1 hour of surgery, whereas an average of 3ml of bmb and 11,79.106 cells./ml were obtained in 30 min from the femur epiphysis with a reduced animal death rate. conclusion: the analysis for the obtention of a larger number of mononuclear cells/ml from rabbit bone marrow blood was more satisfactory in the femur epiphysis than in the iliac crest.
Rehabilitation of Severely Resorbed Mandible Treated With Mini Dental Implants and Iliac Crest Bone Grafts: Case Report
Marija Bubalo,Zoran Lazi?,Radomir Milovi?,Anika ?ukovi?
Acta Facultatis Medicae Naissensis , 2011,
Abstract: Severe pathologic resorption of the mandible may result in weakening of the jaw, unstable dentures, abnormal functions of mastication and speech, and a marked reduction of the facial and vertical dimension. This clinical report describes the rehabilitation of a severely resorbed mandible treated with mini dental implants and an iliac bone graft. A bone graft harvested from the iliac crest was used for the reconstruction of a severely resorbed mandible in a female patient aged 59 years. Six months after graft remodeling, four mini dental implants were inserted. The patient was prostheticaly rehabilitated using an implant retained denture. This treatment was considered to be a beneficial treatment choice in the maintenance of satisfactory functional and esthetic results in patients with severely atrophied alveolar ridges.
Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy  [PDF]
J. Joseph Anderson, Adam F. Gough, Myron H. Hansen, Zflan Swayzee
Stem Cell Discovery (SCD) , 2015, DOI: 10.4236/scd.2015.52002
Abstract: Background: Adult acquired flatfoot deformity is generally mediated with an Evans procedure where a wedge of bone is placed into the calcaneus to better align the foot and decrease the deformity. The purpose of this study was to assess the efficacy and safety of human amniotic allograft applied to allogeneic tri-cortical grafts in Evans calcaneal osteotomy. Methods: The medical records of patients who had Evans calcaneal osteotomy with implantation of tri-cortical iliac crest bone graft with human anmiotic allograft for surgical management of adult acquired flatfoot deformity with 2 years follow-up data were reviewed. Results: A total of 63 patients (mean age: 33.3 yr, range: 18 - 66 yr) were enrolled with adult acquired flatfoot deformity. Median time to weight-bearing was 6 weeks. Time to wearing normal shoes was 10 weeks, and time to radiographic healing was 16 weeks. Conclusions: The use of human amniotic allograft did not diminish the long term outcome of procedure or the short term benchmarks for healing after surgery. There were no nonunion, wound dehiscence, infection, or allergic or immune reaction reported. This retrospective study demonstrated that tri-cortical iliac crest bone graft and HAA could be safely used in Evans calcaneal osteotomy with favorable results.
Comparison of Fusion Rates between Autologous Iliac Bone Graft and Calcium Sulfate with Laminectomy Bone Chips in Multilevel Posterolateral Spine Fusion  [PDF]
Meng-Ling Lu, Tsung-Ting Tsai, Lih-Huei Chen, Po-Liang Lai, Tsai-Sheng Fu, Chi-Chien Niu, Wen-Jer Chen
Open Journal of Orthopedics (OJO) , 2013, DOI: 10.4236/ojo.2013.32023

Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.

Pelvic Multifocal Primitive Bone Epithelioid Angiosarcoma (Iliac Crest and Hip) about One Case and Literature Review  [PDF]
Samba Koné, Abidou Coulibaly, Nawe Astride Ngandeu, Kouadio J. N’dah, Stanislas Touré, Adoulaye Bana, Serge Agoh, N’zué Kouakou
Open Journal of Pathology (OJPathology) , 2017, DOI: 10.4236/ojpathology.2017.73006
Abstract: Epithelioid angiosarcoma is a rare vascular tumour with dark prognosis at short term. The primitive bone localization is exceptional and sometimes presents itself under a unifocal form. We report a clinical case of pelvic multifocal primitive bone epithelioid angiosarcoma (iliac crest and hip) diagnosed on a young male adult (45 years old). The radiological investigations put in evidence geographic osteolytic lesions (type IC) and, diagnostic was given thanks to the histological examination of the surgical biopsy pieces. The evolution was marked by the appearance of pulmonary and lymph node metastases with a death occurring in less than 4 months. Extremely rare tumour, bone epithelioid angiosarcoma is a variant of angiosarcoma characterised by an aggressive nature whose evolution is always fatal. Through this observation we report our experience on the diagnostic approach; and using a literature review we discuss the therapeutic modalities of this tumour with very bad prognosis.
Mandibular segmental reconstruction with iliac crest
AE Obiechina, SO Ogunlade, AO Fasola, JT Arotiba
West African Journal of Medicine , 2003,
Abstract: Twenty patients consisting of 14 males and 6 females with benign destructive lesions of the mandible were reconstructed using free nonvascularised iliac crest. Harvested bone was contoured and secured with 0.5mm stainless steel wire and reinforced with maxillo-mandibular fixation. Five patients has hemimandibulectomy with immediate reconstruction. The other 15 patients had 1 to 3 segments of the mandible reconstructed. There was only one failure. Mouth opening and closure were centric except in the patients that had hemimandibulectomy without condylar reconstruction. Mastication and facial appearance were satisfactory. In conclusion, the iliac crest is recommended for reconstruction of hemimandible as well as long contiguous segments of the mandible.
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