Anatomical basis for retrograde perfusion of the medial femoral condyle corticoperiosteal flap (543.5)

Abstract

Introduction: The descending genicular vessels are widely used for free vascularized corticoperiosteal flaps of the medial condyle in cases with scaphoid nonunions. Due to the small diameter of the artery and the therefor demanding surgical procedure, this study aimed at the possibility of retrograde perfusion of the graft. Material and Methods: The descending genicular vessels (artery and veins) were extracted from 18 formalin‐fixed specimen of the anatomic institute. The samples were severed proximal at the level of the intermuscular septum and traced as far as possible towards the periosteum of the medial condyle of the femur. The veins were inspected macroscopically with help of a surgical microscope. Occurrence, distance and number of venous valves were documented. Results: The samples measured 5,1 ± 18 cm, each artery was accompanied by two veins in most cases (one vein in six specimen, three veins in one specimen, 32 veins in total). These veins had several intervenous connections. Of the 32 veins, 13 veins showed a venous valve, situated 1,6 ± 1,4 cm from the proximal end of the specimen. Of the 18 descending genicular vessels, there existed at least on vein in 14 samples without any venous valve. Conclusion: Provided previous intraoperative examination of the veins, retrograde perfusion of the free vascularized corticoperiosteal flap of the medial condyle and therefor arteriovenous anastomosis seems possible.