Postoperative course of patients treated with iliac osteocutaneous free flaps. A two- to five-year follow-up study

The clinical and radiologic course was reviewed in seven patients treated with an iliac osteocutaneous free flap (iliac flap) for treatment of large bone defects in the tibia and first metacarpal bone and overlying skin. Application of the iliac flap was followed by free bone grafting in four patients and aesthetic surgery in four patients. All patients obtained solid bony union and good skin coverage; none had complaints upon walking. An iliac flap was useful as a salvage procedure for the treatment of massive defect of bone and skin in extremities, especially in the lower one-third of the lower leg. Transient osteoporosis occurred before osteosclerosis and bony union. Bone remodeling with change in the trabecular pattern preceded transformation from cancellous to cortical bone.