Reconstruction of the proximal femur with a vascular pedicle iliac crest graft after tumour resection

Abstract

A useful method of reconstruction of the proximal femur after tumour resection is described. An anterior iliac crest bone graft with an intact vascular supply based on the deep circumflex iliac vascular bundle is used to fill the bone defect. It is swung down to the femur behind the iliopsoas muscle and locked into place in the femur. Sixteen cases of locally aggressive tumours have been resected and reconstructed by this method. Follow-up for five to eight years shows good reconstitution of the femur and hip function without recurrence.

Acetabular roof reconstruction with pedicled iliac graft

“…Therefore, ideally, a bone graft should be transferred from a nearby site so that it need not be detached from its vascular pedicle and the complications associated with a micro-vascular anastomosis avoided. Such pedicled bone grafts have been successfully used since the beginning of the twentieth century but, to our knowledge, they have not been used to augment total hip replacement [4,11,16,19,23,25]. Although there are other possible donor sites available for the reconstruction of the acetabular roof, vascularised iliac bone graft based on the deep circumflex iliac artery is ideal due to the long length of the pedicle and the fact that the vessels are of adequate diameter to allow the procedure [32,34].…”

Acetabular roof reconstruction with pedicled iliac graft: early clinical experience

“…Pedicled iliac graft is one of the most commonly used grafts, because it provides a strong piece of bone while the vascular pedicle ensures excellent bone potential for rapid bone healing [4,5].…”