Fractures of the iliac crest after split-thickness bone grafting for preprosthetic surgery: report of 3 cases and review of the literature

Abstract

Purpose: In this study fractures of the iliac crest after split-thickness bone grafting in a patient population treated for preprosthetic reasons were evaluated.

Patients and methods: In a retrospective patient population of 146 patients, during a 5-year period (1998 to 2002), 3 avulsion fractures of the iliac crest were noticed. All fractures were postsurgical, occurring as late fractures. A review of the literature regarding etiology, clinical characteristics, and results of treatment is given.

Results: In all 3 cases treatment was conservative, consisting of a period of bed rest followed by progressive ambulation. Further recovery was uneventful.

Conclusions: According to this patient population and the literature, late fracture of the iliac crest after split-thickness bone grafting is an uncommon complication. We recommend a harvesting and grafting technique at an appropriate distance from the iliac spine with an oscillating saw. Treatment of an iliac crest fracture is almost always conservative.