The Medial Femoral Condyle Flap: A Novel Versatile Tool for Complex Microvascular Maxillofacial Reconstruction

Abstract

Summary: The medial femoral condyle flap is well-described for reconstruction of small bone defects of the upper and lower extremities. There are limited case reports of its use in other anatomic sites, particularly for reconstruction of complex head and neck defects. In the setting of previous radiation and contaminated fields, vascularized bone is generally preferred to bone grafts, cadaveric allografts, or synthetic implants. The authors present a case series of complex craniofacial defects involving the midface that were reconstructed using medial femoral condyle flaps, focusing on the type of defect and lessons learned from their early experience to promote awareness of this flap among microsurgeons, who may wish to consider the potential of this flap and incorporate its use into their armamentarium. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Innovative Strategies in Microvascular Head and Neck Reconstruction

“…The fibula and scapula continue to be widely used in osseous flaps in the midface region. A recent addition to the armamentarium is the medial femoral condyle (MFC) flap [ 61 ]. The MFC is most commonly used in the reconstruction of extremity defects, in particular, scaphoid non-unions or avascular necrosis of the carpal bones, but its relatively reliable anatomy can also be harnessed for the reconstruction of bony midface defects.…”

Evolution of Medical Modeling and 3D Printing in Microvascular Midface Reconstruction: Literature Review and Experience at MD Anderson Cancer Center

“…While the overwhelming majority of cases are reconstructed with a fibula, VSP technology can also be used with high reliability for other flaps, such as the scapula or iliac crest [24][25][26][27]. A more recent advance in bony reconstruction of the midface was the introduction of the medial femoral condyle (MFC) flap for the reconstruction of midface defects [28]. The use of vascularized bone is recommended in the setting of previous radiation or anticipated adjuvant radiation, which can have a significant detrimental impact on the long-term outcomes.…”