The iliac crest region: donor site for vascularized bone periosteal and soft tissue flaps.

A review is presented of the classic vascularized iliac crest transfer and to show useful variations on this technique. A technical variation to reconstruct mandibular defects, the semisegmented iliac crest graft, is described. Another variation, the half iliac crest graft, is presented for use in the neovascularization of avascular necrosis of the femoral head. When such a flap is raised with a large periosteal flap and overlying muscle or skin, or both, as a composite flap, a primary osteoperiosteal tube can be created to reconstruct segmental defects in long bones. This primary osteoperiosteal tube is secondarily transformed into a completely osseous tube.