title: Technical note: medial approach for proximal tibia bone graft using a manual trephine.
abstract: OBJECTIVE
  The purpose of this review is to assess the use of a manual trephine for harvesting bone grafts from the medial aspect of proximal tibia.
  
  
  METHODS
  The medial approach for proximal tibia is described with detailed landmarks and anatomic relationships, pointing out the advantages of using a manual trephine. A retrospective review of 33 patients who underwent this technique in a 3-year period is reported.
  
  
  RESULTS
  The medial aspect of proximal tibia was found to supply the requirements of cancellous bone graft for all the osseous defects, with the exception of bilateral sinus lifts. There were no major complications at the donor site; only 2 cases of local infection and unaesthetic scar were found, respectively. Morbidity at the receptor site was attributable to the lack of soft tissue coverage.
  
  
  CONCLUSIONS
  Medial approach for proximal tibia with a manual trephine seems to be a valuable tool to harvest autogenous cancellous bone grafts with simplicity, safety, and predictability.
authors.affiliation: Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario del Rio Hortega, Valladolid, Spain. barryentos@gmail.com <barryentos@gmail.com>
authors.forename: F Javier Barrientos
authors.initials: FJ
authors.lastname: Lezcano
authors.forename: Beatriz Peral
authors.initials: BP
authors.lastname: Cagigal
authors.forename: José Miguel García
authors.initials: JM
authors.lastname: Cantera
authors.forename: Gonzalo
authors.initials: G
authors.lastname: de la Peña Varela
authors.forename: Raúl Floriano
authors.initials: RF
authors.lastname: Blanco
authors.forename: Alberto Verrier
authors.initials: AV
authors.lastname: Hernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D012189:Retrospective Studies; D013977:Tibia / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*