[Iliac eventration after posterior iliac bone removal. An original technique of reconstruction]

A tricortical bone graft removal from the iliac crest causes a parietal defect that may be complicated by iliac or iliolumbar eventration, according to the extent of the bone loss. On the basis of their experience with a particularly characteristic clinical case, the authors describe an original reconstruction technique. The surgical techniques aimed at parietal restoration described in the literature include either the use of foreign materials or of those provided by the patient (skin, fascia lata, etc.), or the use of the surrounding anatomical elements to reconstruct a solid wall. Most of these procedures may be difficult to implement if the loss of substance is extensive, or in a posterior site. Thus, in order to prevent possible recurrence in case of major bone defects, we propose to combine the cure of the eventration with a restoration of bone continuity with a cold-conserved allograft and the reconstruction of the musculoaponeurotic curtain by the translation of the lumbosacral fascia. This procedure allowed obtaining a very satisfactory result, which was stable after 18 months both as regards parietal reconstruction and as regards pain, owing to the restoration of balance in the paraspinal muscular support.