AI Article Synopsis
- The study investigates the complication rates of iliac crest bone grafting (ICBG) in pediatric patients undergoing surgery for scaphoid nonunions, hypothesizing that these rates would be lower than those found in adult populations.
- Records from 119 surgeries performed between 1995 and 2016 were analyzed, revealing that only 10 wrists (8.4%) had donor site complications, mainly including pain beyond 30 days and numbness, but no infections or reoperations occurred.
- The findings suggest that donor site morbidity in pediatric patients is lower than reported in older populations, with female patients showing a higher tendency for complications compared to males.
Article Abstract
Purpose: Screw fixation with iliac crest bone grafting (ICBG) is a well-studied treatment for pediatric scaphoid nonunions. Studies in adults, as well as in pediatric spine fusions, have demonstrated high rates of complications with ICBG, including longer-term donor site pain. We hypothesized that in pediatric patients undergoing ICBG for scaphoid nonunion, the donor site complication rate would be lower than that reported in other populations.
Methods: Records of patients ages 0-18 years at a single institution undergoing surgical reconstruction for scaphoid nonunion from 1995 to 2016 were reviewed. Patient and surgical variables were recorded, including how ICBG was harvested. Donor site complications were recorded, including donor site pain beyond 30 days after surgery, infection, peri-incisional or lower extremity numbness at any point after surgery and reoperation at the donor site at any time point after surgery.
Results: During the study period, 119 wrists in 117 patients underwent internal fixation and ICBG for scaphoid nonunion. The average age was 16 years; mean follow-up was 1 year. The majority of wrists (73, 62.9%) underwent harvest of both outer and inner tables of the iliac crest; 38 (31.9%) had only outer table harvested; 5 (4.3%) had only cancellous graft harvested. Ten wrists (8.4%) had a donor site complication. The most common donor site complication was donor site pain beyond 30 days after surgery (5, 4.2%), followed by numbness (4, 3.4%). No infections, seromas, or reoperations at the donor site occurred. In comparison to those subjects who did not experience complications, we found no difference based on the age at surgery or the type of graft used. Female patients were more likely to have a recorded complication than males.
Conclusions: Donor site morbidity for iliac crest grafting in pediatric patients undergoing scaphoid nonunion surgery appears to be lower than that previously reported in adult patients.
Type Of Study/level Of Evidence: Therapeutic IV.
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| http://dx.doi.org/10.1016/j.jhsa.2022.02.007 | DOI Listing |
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