Iliac Crest

Abstract

The iliac crest provides a well-vascularized bone graft which is rich in cancellous bone. Its arterial supply, the deep circumflex iliac artery (DCIA), provides branches to the bone, abdominal musculature and skin. This transfer can be taken in three different configurations: bone only, bone and abdominal musculature, and bone, abdominal musculature and skin. Although the iliac crest has been transferred based on the superficial circumflex iliac vessels, it was not until Taylor described the transfer of this flap based on the deep circumflex iliac artery that it became a reliable flap. However, it has enjoyed a mixed reception by some surgeons because it is a complex transfer to elevate and the multiple curves of the crest are a difficult shape to deal with in the recipient area. Elevation of this transfer can be done only with a thorough knowledge of the relevant anatomy. A study of the three dimensional curves of this bone will reveal that it can be ingeniously incorporated into many bony defects.