Evolution of Using Iliac Crest Bone Grafts to Reconstruct Large Defects of the Mandible on Board the Mercy Ships in West Africa

Abstract

Introduction: In low-income countries which has limited access to healthcare, limited facilities and limited technology to manage patients' benign conditions. An alternative form of treatment without using the latest technology became the work-horse methods. In patients with an extensive slow growing benign mandibular tumour, which often present late, the only treatment option is resection of the mandibular tumour. The gold standard of reconstruction would be free tissue bony transfer which requires microvascular anastomosis and adequate post operative specialist support. A secondary option is the placement of reconstruction plate followed by a bone graft taken from the iliac crest to replace the extensive defect. Method(s): We would like to demonstrate the evolution of using iliac crest bone graft to reconstruct extensive defect after hemi or subtotal mandibulectomy in patients treated on board the Mercy Ships over the last 30 years. As part of Mercy Ships' Education, Training and Advocacy programme, we partner with the host nation's government and train local surgeons this secondary reconstructive option. Outcome(s): Without a form of a bony reconstruction, some patients experienced exposure of the reconstruction plate after extensive mandibular resection. The method of reconstruction with an iliac crest bone graft has been fine-tuned resulting in a successful method of mandibular reconstruction that is effective and functional for the patients.Copyright © 2025