Hernia through an Iliac Crest Bone Graft Harvest Site: Two Cases Treated Differently

Abstract

Background: Bone graft is frequently used during orthopaedic procedures. Multiple complications are associated with bone graft harvest from the iliac crest. Structural bone graft harvest can lead to the development of a rare complication of a hernia through the iliac deficit. Methods: We report two cases of transiliac herniation following a structural bone graft harvest. The first case was a 71 years-old woman who initially underwent a foot fusion with a ipsilateral bone graft harvest. She underwent three surgical hernia repairs using a mesh sutured to the adjacent muscles to cover the defect. At the last follow-up, the patient presented with a third recurrence of the hernia. The second case is a 79 years-old female who initially underwent a total hip replacement associated with an ipsilateral bone graft harvest. Twenty-four years later, she presented with a transiliac hernia. The patient underwent surgery and in this case, the mesh was sutured to bone with a corkscrew anchor. At the last follow-up, the patient did not present any recurrence of the hernia. Conclusion: The use of a corkscrew anchor to fix the mesh rigidly through the iliac bone seems to offer a fast recovery with minimal complications compared to the standard technique where the mesh is loosely fix to the adjacent muscles. This hernia repair technique seems to offer better results and less recurrence. A study comparing the two techniques with more patients involved would help confirm our findings.