Merits of the free periosteal femoral condyle flap in the management of advanced mandibular osteoradionecrosis

Prevost, Alice; Poulet, V; Delanoe, F; Lauwers, F

doi:10.1016/j.ijom.2022.05.006

Cited by 3 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,4,5,10,14,16,18,[20][21][22]28,29,33,36,38,41,42 The mean procedure time ranged from 243 to 540 minutes. 7,8,23,24,29,30,36,37 The overall flap failure rate was 2% (95% CI, 0%-4%; Fig. 2).…”

Section: Resultsmentioning

confidence: 97%

“…Donor site morbidity was reported in 36 studies. 2,4,5,7–11,13–15,17–26,28–42 The most reported postoperative symptoms were transient paresthesia, knee pain, and/or decreased knee mobility. Major complications were rare, with only three cases of femoral fractures, one case of superficial femoral artery injury, one case of medial collateral ligament of the knee injury, and one septic shock due to postoperative pacemaker colonization reported.…”

Section: Resultsmentioning

confidence: 99%

“…8,16,34,41,42 The main indications in the head and neck region were segmental mandibular, maxillary, alveolar ridge, and orbital bone defects. 7,8,[20][21][22]37,41 For subtotal nasal defects, the MFC-FF bony flap was used as a scaffold to support a frontal flap. 10 Brandtner et al described further applications with facial bone, calvaria, skull base, and partial laryngeal defects reconstruction.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Medial Femoral Condyle Free Flap: A Systematic Review and Proportional Meta-analysis of Applications and Surgical Outcomes

Scampa,

Mégevand,

Martineau

et al. 2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Recalcitrant bone nonunion and osseous defect treatment is challenging and often requires vascularized bone transfer. The medial femoral condyle flap has become an increasingly popular option for reconstruction. The study aims at reviewing its different applications and synthesizing its surgical outcomes. Method: A systematic review including all studies assessing surgical outcomes of free medial femoral condyle flap for bone reconstruction in adults was conducted on January 31, 2023. Flap failure and postoperative complications were synthesized with a proportional meta-analysis. Results: Forty articles describing bony reconstruction in the head and neck, upper limb, and lower limb areas were selected. Indications ranged from bony nonunion and bone defects to avascular bone necrosis. Multiple flaps were raised as either pure periosteal, cortico-periosteal, cortico-cancellous-periosteal, or cortico-chondro-periosteal. A minority of composite flaps were reported. Overall failure rate was 1% [95% confidence interval (CI), 0.00–0.08] in head & neck applications, 4% in the lower limb (95% CI, 0.00–0.16), 2% in the upper limb (95% CI, 0.00–0.06), and 1% in articles analyzing various locations simultaneously (95% CI, 0.00–0.04). Overall donor site complication rate was 4% (95% CI, 0.01–0.06). Major reported complications were: femoral fractures (n = 3), superficial femoral artery injury (n = 1), medial collateral ligament injury (n = 1), and septic shock due to pace-maker colonization (n = 1). Conclusion: The medial femoral condyle flap is a versatile option for bone reconstruction with high success rates and low donor site morbidity.

show abstract

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Medial Femoral Condyle Free Flap: A Systematic Review and Proportional Meta-analysis of Applications and Surgical Outcomes

Scampa,

Mégevand,

Martineau

et al. 2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…Furthermore, in cases requiring dental implants postreconstruction, the MFC flap was found to provide adequate bone quality when a suitable amount of cortical bone was procured. 13 , 19 , 21 , 22 In the studies discussing palatal reconstruction, the MFC free flap was found to be an effective reconstructive option for recalcitrant wounds. 13 , 19 , 20 (See table 3, Supplemental Digital Content 3, which displays the recipient and donor site outcomes and complications.…”

Section: Resultsmentioning

confidence: 99%

“…1,12 This poses a limitation, as the SGA's shorter pedicle leads to higher risk of flap complications and failure, much like the iliac crest. 1,12,13,25,26 Laryngotracheal region 19,[32][33][34] Mandible 6,13,22,24,35,36 Maxillary alveolus 13,[19][20][21]37 Orbit 16,20 Palate 13,20 Other facial bony structures 19,[38][39][40] Problematic nonunions 6,20,36 Failed nonvascularized bone grafts 13,19,20,37 Recalcitrant defects 19,20,37 Osteoradionecrosis 13,16,20,22,24 Fig. 2.…”

Section: Discussionmentioning

confidence: 99%

Expanding Indications of the Medial Femoral Condyle Free Flap: Systematic Review in Head and Neck Reconstruction

Patel

Tipps

Bartlett

et al. 2023

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:The medial femoral condyle free flap serves as an attractive reconstructive option for small-to intermediate-sized bony defects. It is commonly applied in the extremities with limited reports in the head and neck. Methods: A systematic review of the literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Seventeen articles met inclusion criteria, yielding 166 cases for analysis, with a majority of the cohort from a single study (n = 107; 64.4%). However, all included studies represented novel reconstructive sites and surgical indications. Flap components were described in 157 cases; periosteum was used only in four cases (2.5%), whereas all others are composed of cortical bone combined with periosteum, cancellous bone, and/or cartilage (97.5%). Additionally, a skin island was used in 43 cases (25.9%). Flap measurements were reported in 51 cases, averaging 4.5 ± 2.7 cm in length. Seven cases listed skin island dimensions, averaging 20.2 ± 12.8 cm 2 . The descending genicular artery was the primary pedicle employed (n = 162; 97.6%), while the superior medial genicular was used in the descending genicular artery's absence (n = 4; 2.4%). Descending genicular artery pedicle length from 15 reporting cases averaged 6.4 ± 1.2 cm. Successful reconstructions totaled 160 cases (96.4%). Recipient complications were seen in 16 cases (9.6%) with six constituting flap failures (3.6%). Donor site complications were minimal (n = 6; 3.6%); however, this included one major complication of femoral shaft fracture. Conclusion:The medial femoral condyle free flap is an effective reconstructive option for the head and neck due to its versatile nature, low complication profile at both recipient and donor site, ease of harvest, and two-team approach.

show abstract

Prevalence of free flap failure in mandibular osteoradionecrosis reconstruction: a systematic review and meta-analysis

Kostares,

Kostare

et al. 2024

Sci Rep

View full text Add to dashboard Cite

Our study aimed to estimate the prevalence of total free flap failure following free flap reconstruction for mandibular osteoradionecrosis (mORN) and assess the impact of potential moderators on this outcome. A comprehensive systematic literature search was independently conducted by two reviewers using the Medline, Scopus, Web of Science and Cochrane Library databases. Quality assessment of the selected studies was performed, and prevalence estimates with 95% confidence intervals (CI) were calculated. Outlier and influential analyses were conducted, and meta-regression analyses was employed to investigate the effects of continuous variables on the estimated prevalence. Ultimately, forty-six eligible studies (involving 1292 participants and 1344 free flaps) were included in our meta-analysis. The findings of our study revealed a prevalence of 3.1% (95% CI 1.3–5.4%) for total free flap failure after reconstruction for mORN. No study was identified as critically influential, and meta-regression analysis did not pinpoint any potential sources of heterogeneity. These findings provide valuable insights for researchers and serve as a foundation for future investigations into the management of mandibular osteoradionecrosis and the prevention of free flap failure in this context.

show abstract

Merits of the free periosteal femoral condyle flap in the management of advanced mandibular osteoradionecrosis

Cited by 3 publications

References 27 publications

Medial Femoral Condyle Free Flap: A Systematic Review and Proportional Meta-analysis of Applications and Surgical Outcomes

Medial Femoral Condyle Free Flap: A Systematic Review and Proportional Meta-analysis of Applications and Surgical Outcomes

Expanding Indications of the Medial Femoral Condyle Free Flap: Systematic Review in Head and Neck Reconstruction

Prevalence of free flap failure in mandibular osteoradionecrosis reconstruction: a systematic review and meta-analysis

Contact Info

Product

Resources

About