WP1.4 - Iliac Crest Bone Grafts and Hernia Formation: Insights from a Case Series And Review of Literature

Abstract Introduction Hernias following iliac bone grafting are a rare but significant complication, with the earliest case reported in 1945. Repair of these hernia is challenging. There is a need for appropriate repair techniques to minimize morbidity and recurrence. We present our experience with 3 cases of post-iliac graft hernia repair and a systematic review of current literature. Method We conducted a systematic review of literature in two online databases, PubMed®/ MEDLINE and EMBASE) February 2024, following PRISMA guidelines. Keywords used were “Hernia”, “iliac”, and “Graft”. Data on demographics, initial pathology, time to presentation, type of hernia repair, and outcome were collected. Studies not in English and related to other types of hernia were excluded. Results 31 studies, spanning from 1975-2023, were included of 751 results. There were 41 reported cases of hernias post iliac bone grafting. Age distribution ranged from 37-88 years, with an average age of 59 years. Average time of presentation was 4 years. 8 cases (25.8%) of recurrence were reported. The main indication for bone grafting was fracture with delayed/ non-union in 20 cases (64.5%). Mesh repair was performed in 70% of cases. Average follow-up period was approximately 17 months. Conclusion Hernias post iliac bone grafting should be suspected as a probable complication. If identified, most can be managed with mesh, however patients need to be followed up due to risk of recurrence.