A Novel Technique for Iliac Crest Reconstruction After Autologous Bone Harvest with Titanium Bone Plate and Screws, And HydroSetTM - Case Report

¹Doctor of Dental Surgery, Oral and Maxillofacial surgeon, PhD in OMFS, Post-Doctorate at Baylor University Medical Center and Baylor College of Dentistry, Dallas - TX, USA, Assistant Professor OMFS Department at West Virginia University School of Dentistry (WVVUSOD), Morgantown - WV, Active member of the ASTMJS, USA

²Doctor of Dental Surgery, Fourth Year Resident – Resident Chief - OMFS Department at WVUSOD, Morgantown-WV, USA

³Doctor of Dental Surgery, Third Year Resident OMFS Department at WVUSOD, Morgantown-WV, USA

⁴Doctor of Dental Surgery, Second Year Resident OMFS Department at WVUSOD, Morgantown-WV, USA

*Corresponding author: Eber Luis de Lima Steolo, DDS, EdS, PhD, Doctor of Dental Surgery, Oral and Maxillofacial surgeon, PhD in OMFS, Post-Doctorate at Baylor University Medical Center and Baylor College of Dentistry, Dallas - TX, USA, Assistant Professor OMFS Department at West Virginia University School of Dentistry (WVVUSOD), Morgantown - WV, Active member of the ASTMJS, USA, Phone: 304 2828438, E-mails: [email protected]; [email protected]

Received Date: January 31, 2025

Publication Date: March 21, 2025

Citation: Steolo ELDL, et al. (2025). A Novel Technique for Iliac Crest Reconstruction After Autologous Bone Harvest with Titanium Bone Plate and Screws, And HydroSet^TM - Case Report. Cases. 4(1):20.

Copyright: Steolo ELDL, et al. © (2025).

ABSTRACT

Background: The iliac crest (IC) has been for decades the golden standard autologous bone graft donor site, although associated with pain, intense intraoperative cancellous bone bleeding, postoperative hematoma formation, hip aesthetic defect, iliac instability and/or fracture. Reconstruction of the IC after bone grafting has recent gained attention minimizing complications, bringing this IC to the main option when autogenous bone grafting is needed in great quantity. Methods: The authors present a case report on a patient who underwent inner anterior left IC corticocancellous harvesting for maxillary bone reconstruction. Rigid fixation of the defect was obtained with a 2.0 titanium bone plate fixated to the superior border of the IC with four titanium screws, and a self-setting calcium phosphate cement intended for use in the repair or restoration of bony contour in human skeleton. Results: Trans-operative bleeding was minimal due to a careful use of ultrasonic surgery technique, reducing postoperative hematoma formation. Minimal postoperative donor site pain and early painless ambulation on this patient significantly differed from previous descriptions on scientific literature due to several aspects described in details on this article but the authors impute the final success of this new surgical technique to a very careful IC muscle dissection and primary stability of the hip with titanium bone plating and screw fixation, and hydroxyapatite cement extra support. Conclusion: Even though there is a tremendous stigma when iliac crest bone harvesting (ICBH) is the option for autologous corticocancellous bone harvesting due to several aspects such as bleeding, pain, hematoma, ambulation and pronounced scar. A careful and punctilious surgical technique which avoids drills and saws, followed by reconstruction of the IC with rigid fixation, mediated by a meticulous postoperative pain protocol, intraoperative bleeding can be attenuated, postoperative pain tremendously reduced, early ambulation staggeringly improved, and scar reduced with appropriate and compressive postoperative dressings. The surgical procedures described on this article should be considered as an excellent technique for ICBH due to its various benefits when compared to the traditional techniques which do not consider donor site reconstruction.

Keywords: Iliac Crest Bone Graft, Bone Harvest Morbidity, Reconstruction of Pelvic Donor Site, Bone Cement, Hydroxyapatite Iliac Reconstruction, Autologous Bone Harvest