A case of Osteomyelitic sinuses of the ilium with lower abdominal defect following a run over accident is treated with primary excision of sinuses
with bone and reconstruction using pedicled anterolateral thigh flap. The Anterolateral thigh flap is a versatile pedicled flap1,2 for  the reconstruction of the abdominal wall more effective and efficient than
the fascia lata flap or other rotation flaps. Here is a case report  describing the procedure and outcome in a complicated case.
Keywords: Anterolateral thigh flap; Abdominal
defects; Osteomyelitis of the pelvic bones; Sinuses of
lower abdominal regions.