The medial femoral condyle free osteocutaneous flap for osteomyelitis in pilon fractures

Upper and lower extremity reconstructive applications utilizing free flaps from the medial genicular arterial system: A systematic review

“…Several groups have reported outcomes following MFC flap treatment of tibial (Caterson, Singh, Turko, Weaver, Talbot, ; Cavadas and Landin, ; Choudry, Bakri, Moran, Karacor, Shin, ; Hamada, Hibino, Kobayashi, 2014; Rodriguez‐Vegas and Delgado‐Serrano, ; Vegas, Delgado, Roger, 2012) and femoral (Choudry, Bakri, Moran, Karacor, Shin, ; Hamada, Hibino, Kobayashi, 2014) nonunions (Table ).…”

“…Six publications were identified that treated tibial nonunions with the MFC flap, comprising a total of 35 patients (Caterson, Singh, Turko, Weaver, Talbot, ; Cavadas and Landin, ; Choudry, Bakri, Moran, Karacor, Shin, ; Hamada, Hibino, Kobayashi, 2014; Rodriguez‐Vegas and Delgado‐Serrano, ; Vegas, Delgado, Roger, 2012) (Table ). Diagnoses included infected (6%) and noninfected (94%) nonunions, and 6% had concomitant large soft tissue defects receiving simultaneous free latissimus flaps for soft tissue coverage.…”

“…Minor complications include transient medial knee numbness, and nonoperatively‐managed donor site seromas. An additional patient underwent debulking of the cutaneous portion of a chimeric flap (Caterson, Singh, Turko, Weaver, Talbot, ). As the sole comparative study amongst the five, Hamada et al () observed a 100% (3/3) union rate at a mean of 3.2 months with MFC treatment, versus 60% union at 7.7 months with NVBG.…”

“…The MGA flap is versatile and well‐suited for reconstruction of a wide array of orthopaedic pathology including fracture nonunion (Al‐Jabri, Mannan, Giannoudis, ; Cavadas and Landin, ; Choudry, Bakri, Moran, Karacor, Shin, ; De Smet, ; Del Pinal, Garcia‐Bernal, Regalado, Ayala, Cagigal, Studer, 2007; Doi, Oda, Soo‐Heong, Nanda, ; Doi and Sakai, ; Fei, Danmou, Dong, Wei, Eberlin, Yan, 2015; Fuchs, Steinmann, Bishop, ; Hamada, Hibino, Kobayashi, 2014; Jones, Rhee, Bishop, Shin, ; Jones and Shin, ; Kakar, Duymaz, Steinmann, Shin, Moran, ; Rodriguez‐Vegas and Delgado‐Serrano, ; Pelzer, Reichenberger, Germann, ; Rahmanian‐Schwarz, Spetzler, Amr, Pfau, Schaller, Hirt, ; Sakai, Doi, Kawai, ; Sananpanich and Kraisarin, ), avascular necrosis (AVN) (Burger, Windhofer, Gaggl, Higgins, ; Doi and Sakai, ; Holm, Vangelisti, Remmers, ; Jones, Burger, Bishop, Shin, ; Larson, Bishop, Shin, ), failed arthrodesis (Grant, Berger, Ireland, ; Henry, ), infection (Caterson, Singh, Turko, Weaver, Talbot, ), loss of the Achilles tendon and calcaneal insertion (Haddock, Alosh, Easley, Levin, Wapner, ; Haddock, Wapner, Levin, 2013; Huang, Wang, Xu, Wang, Wu, Zhang, 2011; Mattiassich, Marcovici, Dorninger, Kerschhagl, Buerger, Kroepfl, 2014; Paier, Burger, Rab, ; Sananpanich and Kraisarin, ), and osseous defects (Bakri, Shin, Moran, ; Giessler and Schmidt, ; Rodriguez‐Vegas and Delgado‐Serrano, ; Ruston, Amin, Darhouse, Sivakumar, Floyd, ; Sakai, Doi, Kawai, ; Sammer, Bishop, Shin, ; Sananpanich and Kraisarin, ; Wong, Higgins, Katz, ) with or without overlying soft tissue loss. Many studies in the literature are limited by small numbers of patients, or are heterogeneous and report multiple flap recipient sites.…”

Chronic osteomyelitis: what the surgeon needs to know

“…27 Local flaps including muscle flaps, pedicled muscle flaps, myocutaneous flaps and osseous flaps have been used to optimise the impaired soft tissue envelope, with good results. 6,19,20,28 . Vascularised free flaps have also been used to cover large defects where the local tissues are impaired.…”