Hernia through an Iliac Crest Bone Graft Site: A Case Report.

Use of autologous bone grafts is common in orthopedic reconstruction. The most common source for autologous bone graft is the iliac crest. This procedure, however, may be associated with considerable morbidity. We reported a case of lumbar incisional hernia following prior anterior iliac crest bone harvesting in a female patient who had undergone bilateral total hip arthroplasty 2 years ago. She was hospitalized for acute pain in abdomen with vomiting and constipation, found to have herniation of left colon with incarceration through the abdominal wall defect above the iliac crest. She underwent successful mesh hernia repair. Despite its rarity, these hernias should be included within the differential diagnosis of flank masses.

Uso do transfer-control bone replacing system para realização de enxertos autógenos em bloco – apresentação de dois casos clínicos / Use of the transfer-control bone replacing system for autogenous bone block grafting: presentation of two clinical cases

Os enxertos em bloco de osso autógeno são a principal opção para ganhos em espessura em atrofias severas do rebordo. Apesar de ser considerado padrão-ouro, a técnica de remoção do enxerto ósseo aumenta a morbidade das reconstruções. O uso do Tranfer-Control Bone Replacing System apresenta uma excelente alternativa para estas reconstruções, pois permite uma perfeita adaptação do bloco removido ao seu leito receptor com menor morbidade em relação às técnicas convencionais. Este trabalho apresenta o relato de dois casos clínicos de diferentes pacientes para realização de enxerto ósseo autógeno em bloco com o sistema mencionado, removido da linha oblíqua externa, para ganho de espessura óssea para posterior reabilitação com implantes osseointegrados. Em ambos os casos, o bloco foi realizado na região do elemento 14, e o resultado obtido com a técnica permitiu a instalação dos implantes na posição desejada.

Autogenous bone block grafts are the main option for augmentation in severely atrophic areas. Despite being the gold standard, current techniques for bone removal increase local patient morbidity. The Transfer-Control Bone Replacing System represents an alternative technique because it allows for ideal adaptation of the harvested block to the receptor site with less morbidity when comparted to traditional techniques. This paper illustrates two clinical case reports where the use of the aforementioned system is made at the oblique external line to gain thickness before dental implant placement. in both cases, the bone block was grafted at the maxillary premolar region providing adequate sites for three-dimensional implant placement.

Three dimensional linear measurement of proximal tibia in medial and lateral approach for bone harvesting

PURPOSE : The aim of this study was simply assessing linear measurements in the lateral and medial approach, respectively, for bone harvesting using anatomic and three-dimensional (3D) computed tomographic (CT) analyses on a dried cadaveric proximal tibia. In addition, the availability of the three-dimensional computed tomographic (3D-CT) analysis was also estimated. MATERIALS AND METHODS : Ten dried proximal tibia were obtained from five Korean cadavers. Four the reference points, the SM (superior-medial), IM (inferior-medial), SL (superior-lateral), and IL (inferior-lateral) were marked around the tibial tuberosity. The PM (posterior-medial) and PL (posterior-lateral) points were randomly marked at points farthest from the lateral and medial reference points, respectively, in the posterior border of the superior articular surface of both condyles. All measurements were obtained on the dried proximal tibia. After computed tomography had been performed, the three dimensional images were reconstructed using V works 4.0(TM) (Cybermed Inc., Seoul, Korea), and the length between the reference points were measured three dimensionally using the method described above. The error between the mean actual and mean 3D-CT measurements was calculated in order to determine the availability of the three dimensional computed tomographic analysis. RESULTS : The length between the reference points was greatest at the IL-PM, which averaged 65.39 mm+/-10.35. This was followed by the SL-PM with 63.24 mm+/-8.10, the IM-PL with 58.09 mm+/-10.02, and the SM-PL with 51.99 mm+/-9.06. The differences between the IL-PM and SM-PL were 13.4 mm. The mean values were 55.04 mm in the medial approach and 64.32 mm in the lateral approach, and the differences between medial and lateral were 9.28 mm. The error between the mean actual and mean 3D-CT measurements was 0.31% and the standard deviation was 0.28%. CONCLUSION : The anatomical and three dimensional computed tomographic analysis indicates that there was only a 9.28 mm linear difference between the lateral and medial approach. This is consistent with previous studies, which showed that there was little difference between the two approaches in terms of the bone volume. In addition, the error (0.31%) and the standard deviation (0.28%) were considered low, demonstrating high accuracy of 3D-CT. Therefore it can be used in preoperative treatment planning.