Complications of iliac crest graft and bone grafting alternatives in foot and ankle surgery.
Complications of iliac crest graft and bone grafting alternatives in foot and ankle surgery.
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DOI：
10.1016/s1083-7515(02)00128-6
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发表时间：
2003-03-01
影响因子：
1.5
通讯作者：
Boone, David W
中科院分区：
文献类型：
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作者：
Boone, David W
在骨科医生的手术设备中，获取髂骨的能力是一项成熟的技能。和任何外科手术一样，这个手术也有它自己的并发症。外科医生必须意识到这些潜在的问题，尽可能避免它们。外科医生也可以选择其他自体骨摘取部位，但他/她应该了解这些部位的位置、使用限制、摘取技术和潜在的陷阱。在脊柱外科或关节翻修手术中，足部和踝关节外科医生几乎总是比我们的同事需要更少的骨移植，因此这些其他部位可能比髂骨更适合进行骨移植。作为一种减少发病率和手术时间的方法，非自体替代物越来越多地被骨科医生所采用。斯克兰顿最近发表了一篇文章，讲述了他在脚和脚踝重建案例中使用几种不同的骨替代产品的成功。随着这些选择变得更加多样化，知道选择哪种产品变得更加困难。了解骨移植在骨传导、骨诱导和成骨方面的生物学特性，为外科医生在选择骨移植方案时做出明智的选择提供了必要的知识。在选择另一种移植物材料之前，外科医生还应该调查移植物材料在与他或她的病人需要相似的情况下的表现。在未来，随着研究的不断深入，组织工程和基因治疗领域将为非自体骨移植材料提供更好的选择。
The ability to harvest iliac crest bone is a well-established skill in the surgical armamentarium of the orthopedic surgeon. As with any surgical procedure, this operation has its own set of complications. The surgeon must be aware of these potential problems in an effort to avoid them when possible. Other autologous sites for bone harvest are available to the surgeon, and s/he should be aware of these in terms of location, limitations of use, harvest technique, and potential pitfalls. The foot and ankle surgeon almost always needs less bone graft than our colleagues in spine surgery or joint revision surgery, so these other sites may be more suitable than the iliac crest for obtaining bone graft. Nonautogenous alternatives are becoming increasingly available to the orthopedist as a way to decrease morbidity and operating times. Scranton recently published an article about his success with several different bone substitute products that are used in foot and ankle reconstructive cases. As these options become more varied, it becomes more difficult to know which product to select. Understanding the biology of bone grafting with respect to osteoconduction, osteoinduction, and osteogenesis provides the surgeon with the knowledge that is needed to make an informed choice when selecting a bone grafting option. Before choosing an alternative graft material, the surgeon should also investigate how the graft material has performed in cases similar to his or her patient's needs. In the future, with continued research, the fields of tissue engineering and gene therapy will provide even better options for nonautogenous bone graft material.