Abstract Iliac crest bone grafts are a cornerstone in reconstructive and orthopedic surgery due to their superior biological properties. Yet they carry a risk of rare complications, such as herniation at the donor site, with an incidence of 5%–9%. This report highlights an uncommon case of herniation through a bone graft donor site in a 67-year-old male, focusing on its clinical and surgical management. The patient presented with progressively enlarging, reducible lumbar swelling following two iliac crest bone grafts performed during revision surgeries for total hip replacement complications. Imaging revealed a posterior abdominal wall defect with herniation of abdominal contents. The surgical intervention involved an open hernioplasty with mesh repair, leading to an uneventful recovery and no recurrence. This case underscores the importance of meticulous surgical technique and early recognition of donor site complications. Tension-free hernioplasty is effective in managing such cases, while preventive measures, including preserving the iliac crest structure and considering alternative grafting materials, may mitigate risk.
Kedage et al. (Tue,) studied this question.