Complications at removal sites of autologous cancellous bone transplants

: 1022 autologous bone transplants were performed at the University clinic of Ulm in the years 1971-1977. The cancellous bone deposits removed were localized in the anterior and posterior iliac crest, the trochanter major, the tibial head as well as the distal radius. Since some patients had postoperatively experienced difficulty in the healing of the cancellous bone removal sites, we decided to investigate these complications by means of questionnaires, clinical re-examinations as well as X-ray controls (3-9 years after removal). During the early postoperative phase (2 months), approximately one-fifth of the patients had complained about pain at the removal site. 3.1% had more or less pronounced hematomas in the scar regions, but surgical evacuation of the hematoma was necessary in only 0.28%. Additionally, 2 cases of infection as well as one femoral neck fracture following cancellous bone removal from the greater trochanter were observed. At the time of re-examination, performed 3-9 years after cancellous bone removal, only 3.9% of the patients complained of largely weather-influenced pains in the vicinity of the cutaneous scars. Sensibility disorders in the area innervated by the N. Cutaneous femoralis lateralis, were found in all those 7 patients who, in the course of cancellous bone removal from the iliac crest, had received skin incisions extending ventrally beyond the spina iliaca anterior superior. The X-ray controls showed more or less pronounced changes in the bone structure at the removal sites of cancellous bone deposits in nearly all patients, but correlation could only be determined between the radiological alterations at the anterior iliac crest donor site and the respective complaints of the patients.