Face Reconstructed from Genital Area

Bone grafting seems to shift from hips to genitalia.

A new technique will sample the pubic bone for getting grafting material against the iliac (hip bone), which is more prone to complications.

"With further study, the pubic bone could become the new standard for harvesting bone grafts for certain types of reconstructive surgery," write Dr. John W. Polley and colleagues of Rush University Medical Center, Chicago.

The team developed the new technique by harvesting pubic bone in a series of cadaver dissections.

The researchers discovered that the pubic bone, situated at the front of the pelvis, just above the genital area, could be easily reached through a small incision, about 1 inch (2.5 cm).

The importance of the method is given by the minimal dissection of the soft tissue necessary to expose the pubic bone and collect the cancellous bone (sponge-like interior bone) needed for grafting.

The team employed the new technique for the first time in a 10-year-old boy suffering for a cleft palate condition. The procedure for the grafting proved quick and simple and the patient recovered without problems and with little or no pain in the pubic area.

Standard grafting technique uses the iliac crest for harvesting bone grafts for reconstructive surgery, for face or jaw, but the area proved tricky as several complications can happen after the iliac crest procedure, like nerve injuries, pain problems, and scarring.

"The pubic bone graft technique is a promising approach to avoiding these problems," wrote the research team.

The smaller incision made in pelvic area is much less traumatic than grafting bone from the iliac crest site.

As the pelvic area is poor in nerves and less sensitive, the risk of nerve injury is low.

And a scar in that area is less conspicuous as it is in an area normally covered by hair, underwear or swimming suit.

"The pubic bone graft compares favorably with more traditional techniques of cancellous bone harvesting," concluded the team.

The team thinks that the pubic bone graft could be the new standard for those undergoing cleft palate reconstructions.