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Abstract Objective To explore the feasibility and clinical effect of minimally invasive bone harvest from fixed site of posterior iliac crest.Methods From June 2012 to May 2018，40 patients with delayed union and nonunion required bone graft were randomly divided into experimental group and control group.There were 20 cases in each group.The experimental group was treated with minimally invasive posterior iliac crest bone harvest，while the control group was treated with traditional open bone harvest.The operation time，incision length，blood loss during operation and postoperative complications were analyzed，and the bone healing of delayed union and nonunion were followed up.Results In experimental group，the operation time was (15.70±3.61)min，the incision length was(1.42±0.28)cm，the operative bleeding was (16.05±4.72)mL，the wound healed as expected.Local Hematoma was the only complication.In 3 cases，local hematoma appeared and could subside without serious complication.Incontrol Group，theoperation time was(37.90±4.99)min，incision length was (5.02±0.50)cm，operative bleeding was (49.50±8.72)mL，wound infection and poor healing in 2 cases，injury of lateral femoral cutaneous nerve in 2 cases，bone pain in 3 cases and iliac bone depression in 2 cases.The operation time，incision length and bleeding of the two groups were significantly lower than that of the control group (P＜0.01).There were significant differences in the incidence of postoperative complications (P＜0.05).There was no significant difference in the bone healing rate of delayed union and nonunion between the two groups (P＞0.05).Conclusion Both minimally invasive posterior iliac crest osteotomy and traditional open bone harvest can achieve the goal of autologous iliac bone grafting，but minimally invasive posterior iliac crest bone harvest has the advantages of less surgical injury，less bleeding，simple operation and fewer complications.
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