Intracortical Versus Anteromedial Approach for Iliac Crest Bone Harvesting in Preprosthetic Surgery: A Randomized Prospective Clinical Trial

Purpose: The aim of this study was evaluate the morbidity after anterior iliac crest bone harvesting by comparison of 2 approaches: medial and intracortical. Patients and Methods: Between April 2006 and February 2010, 73 consecutive subjects underwent anterior iliac crest bone harvesting. The sample was divided in 2 groups: 37 subjects treated with the medial approach and 36 with the intracortical approach. Patients were monitored during their hospital stay, considering the postoperative complications, the analgesic requirements, resumption of the ambulation, and length of stay. Postoperative controls were performed at 7, 14, and 30 days 6 and 12 months after surgery. A questionnaire on patient's satisfaction and complaints was released. Results: The 2 approaches resulted in significant statistical differences in 3 areas: the average time of operation, recovery of gait capabilities, and duration of the postsurgical pain were lower when intracortical approach was used. Discussion and Conclusion: The low postsurgical morbidity can be related to the minimal muscular detachment, and the risk of fracture is reduced. Bone wax is not necessary for the hemostasis. We consider intracortical approach to be ideal in the case of selected transversal maxillary atrophies.