Improving the iliac crest donor site by plate insertion after harvesting vascularized bone

The iliac crest is among the most frequent sites for free vascularized bone donation. However, donor site morbidity is often marked with persistent pain, abnormal sensation, abdominal herniation, musculoskeletal imbalance and a disfigured appearance. The authors present a technique of reconstructing the bony gap after iliac crest harvest by inserting a metal plate. Apart from restoration of the iliac contour after skin closure, the plate enables fixation of the transected abdominal wall muscles. This results in less postoperative pain and shorter rehabilitation, as well as an improved musculoskeletal balance and a reduced risk of abdominal wall herniation.