Despite advances in fracture management, it is an ongoing challenge to orthopedic surgeon to treat combined injury with extensive soft tissue trauma and large bone defect that was incurred by up-speeding industrial and traffic accidents. The deep circumflex iliac artery provides major vascular supply to the anterior iliac crest and this portion is favored as the optimal vascular pedicle for large bone and skin defect. The authors have performed vascularized iliac osteocutaneous flap transfer based on the deep circumflex iliac artery and accompanying vein in 22 cases from June, 1980 to March, 1989 at the department of orthopedic surgery, Korea University hospital and department of orthopedic surgery, Hanyang University Hospital. The results are as follows:1. We obtained good end results for extensive bone and skin defects with only one-stage operation. 2. Average time of bony union was obtained 3 months after surgery. 3. Among 22 cases, we experienced partial skin necrosis in 4 cases, limited grafted bone resorption in 3 cases and there was no fracture of grafted bone nor recurrence of osteomyelitis.