Background and Objective

For many plastic surgeons, procedure of election in the management of alveolar cleft is to take iliac crest as donor area as it is an easy surgical technique, with high availability of tissue and adequate reproducibility. The available literature regarding the use of olécranon as a donor area for alveolar cleft management is scarce.

Our aim is to describe the results of olécranon cancellous bone graft management for patients with nasoalveolar cleft, compiling a more than 10-year experience performing this procedure and focusing on the low morbidity generated.

Methods

We conduct a descriptive, cross-sectional study on patients with a diagnosis of unilateral or bilateral cleft lip and palate to whom olécranon bone grafts were performed preserving a bone cortical window to close de defect. Sociodemographic variables were collected such as age, sex, origin, diagnosis, number of grafts; and clinical variables such as surgery time, post-surgical pain, time of hospitalization, days of return to daily activities and complications. Patients were clinically evaluated at the first control 4 days after surgery.

Results

Data were obtained from 111 patients, to whom 146 cancellous bone graft from olécranon were performed. Surgical time ranged from 1 to 1.5 hours. Return to daily activities ranged from 2 to 4 days after surgery. Five patients presented post-surgical pain in the donor area (grade III-IV in the pain scale according to the facies)., and only in the first and second time of grafts. Of those patients, 4 were diagnosed as grade III and 1 as grade IV according to Veau. Four returned to daily activities 4 days after surgery and 1 after 3 days. At the time of bone grafting, 1 patient was 4 years old, 2 were 5 years old, 1 was 6 years old, and another one was 8 years old.

Conclusions

With the proposed modification we obtain only cancellous bone graft preserving cortical surface for ulterior close of the bone window created on the olécranon. Our serie of patients evidence a reduced surgical time, the presence of pain only in a low percentage of patients and their return to daily activities in 2-4 days after surgery.

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