The use of bone grafts, using both membranous and endochondral bone, has become standard practice in craniomaxillofacial surgery. Bone from cranium, rib, or ilium can be used as either onlay or inlay grafts to reconstruct the craniofacial
skeleton.
Cranial bone has beconme a frequent source of material for bone grafting, as there was less resorption of cranial bone as membranous bone than with rib or ilium as endochondral bone. But we do not like it because of its difficulty of procurement
and
brittleness of the bone and exposure of cranial cavity. Rib graft can be bent easily and obtained large amount, but pnemothorax as complication can be occurred. In case of multiple trauma patient, if pnemothorax or hemothorax pre-exist, it impose
burden
on a operator as source of bone graft. We prefer iliac bone as our favorite source of bone graft, despite of high resorption rate, to decrease donor morbidity and harvesting time of bone graft in case of multiple trauma patient. To reduce
resorption
rate, we try that the periosteum was preserved as possible, and contact surface was increased through exact shaping, and rigid fixation with miniplate or lag screw was performed. On onlay bone graft, the cortical surface of graft was placed in
contact
with overlying soft tissue and the cancellous surface was placed in contact with recipient bone.
Authors have performed iliac bone graft in 18 patients during a 3-year period, and have obtained favorable results. The clinical cases and a review of the literature are here reported.
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