Dr. Complications of Mandibular Reconstruction with Anterior Iliac Crest Bone Graft

Abstract

Background

Iliac crest bone graft surgery has both donor and recipient site complications. Infection is the most reported complication and, ensuring markedly reduced dead space during wound closure, reduces saliva contamination, and lowers recipient site infection. The purpose of this study is to evaluate the donor and recipient site complication rates, identify potential risk factors to these complications and further evaluate factors associated with failure of iliac crest bone graft following mandibular reconstruction.

Methodology

This was a retrospective study from an institution’s cohort of mandibular reconstruction with iliac crest bone graft, performed for lateral mandibular defect following mandibulectomy for benign tumours. Data collated include case demographics, primary pathology, types of mandibulectomy, defect classification, harvested graft dimensions, post-operative complications, graft survival and reconstruction outcomes.

Results

A total of 64 subjects underwent iliac crest grafting and of these 23 (36%) were females while 41 (64%) were males.  Most of the diagnoses were solid / multicystic ameloblastoma with 56.3% (36/64). Based on the used defect classification, the prevalent mandibular defect was H which comprised of 68.8% (44/64) of all cases while L had 31.2% (20/64) of all cases. 20% (13/64) of all cases experienced infection at recipient site. The average graft length was 5.5 ± 0.45cm. The functional and aesthetic outcomes were excellent for 51.6%(33/64) and good for 43.7% (28/64) of all cases.

Conclusion

This study suggested an association between post-operative complications with defect size, graft dimension and meropenem administration.