Proximal Tibial Cancellous Bone Grafting In Mandibular Reconstruction: Experience From Sokoto, Northwest Nigeria

Abstract

Introduction  
Use of proximal tibia as a donor site has been applied in reconstruction of maxillofacial defects. Cancellous bone graft is available for harvest from the medial and lateral aspects of the proximal tibia. Knowledge of important anatomic landmarks can be used preoperatively to allow for safe dissection and harvest of autogenous bone from the proximal tibia. The purpose of this study was to highlight our experience with the use of proximal tibial cancellous bone graft in the reconstruction of oral and maxillofacial defects and to evaluate donor site morbidity following its harvest.

Material and methods
The medial and lateral approaches to proximal tibia were described with detailed landmarks and anatomic relationship as reported by Benninger B et al. A review of patients who underwent this technique at Usmanu Danfodiyo University Teaching Hospital, Sokoto in a 2- year period is reported.

Results
A total of 12 patients were seen during the review period. There were 6 males and 6 females aged 23-50 years. Eight (66.7%) cases had medial approach, 2 (16.6%) cases had lateral approach and 2 (16.6%) cases had combined approach. Complications observed at donor sites were excessive immediate postoperative bleeding and unsightly scarring.

Conclusion
The medial and lateral proximal tibial bone are useful sites for obtaining cancellous bone graft. Choice of approach in the harvest of proximal tibial bone should be patient specific, giving due consideration to the volume of bone required, desire for early ambulation and presence of underlying systemic disease that may impair wound healing (e.g. diabetes mellitus).