Reconstruction of proximal femoral defects with a vascular-pedicled graft.

A new method of treating large bony defects of the proximal femur is described. The defect is filled with a large vascular-pedicled bone graft from the iliac crest. The graft, being nourished by the deep circumflex iliac vessels, remains viable and therefore induces rapid healing of the bone. This method of bony replacement encourages adequate excision of potentially malignant bone lesions and provides sufficient mechanical support to allow early walking. Six clinical cases are presented to illustrate its application.