The medial femoral condyle free flap: An excellent option for difficult cases: case series

Abstract

The use of the medial femoral condyle free flap is a versatile option for the treatment of upper extremity non unions and reconstructive procedures associated with bone loss or osteonecrosis. The benefit of this type of flap is the viability of the bone which favors primary ossification and increases bone density. Vascularized free bone flaps are especially useful for the treatment of recalcitrant nonunions, or nonunions that have failed three or more treatments to obtain consolidation. We present a case series of three patients treated with medial femoral condyle free flap for reconstruction of the upper extremity of different etiologies at the level of the distal humerus, distal radius and distal phalanx of the thumb.

Reconstruction of the Fourth Metacarpal Using a Chimeric Medial Femoral Condyle Vascularized Osteochondral Cutaneous Graft

“…5,15 Considering the fact that this graft is versatile, offers the possibility of taking a chimeric graft, and has a reliable vascular anatomy, it has become a popular alternative for reconstruction of bone defects of the hand. 5,6,16,17 This case stands out because of the complete reconstruction of the metacarpal head, harvesting with a skin paddle for tension-free closure and monitoring, and the use of external fixation for immediate postoperative mobilization. Small vascularized osteochondral grafts have been used previously for partial reconstruction of the metacarpal head.…”

“…The transfer of a free vascularized graft from the second proximal interphalangeal joint of the foot remains an alternative for active patients, especially for young patients with open epiphyseal plates 22,23 . However, previous reports suggest that the donor site morbidity of the second proximal interphalangeal joint is significantly higher than the femoral condyle 15,16,23 …”

“…The medial femoral condyle graft has proven to be an excellent option for reconstruction of metacarpal bone defects of up to 3 cm 5,15 . Considering the fact that this graft is versatile, offers the possibility of taking a chimeric graft, and has a reliable vascular anatomy, it has become a popular alternative for reconstruction of bone defects of the hand 5,6,16,17 …”

“…22,23 However, previous reports suggest that the donor site morbidity of the second proximal interphalangeal joint is significantly higher than the femoral condyle. 15,16,23…”

Reconstruction using a free vascularised medial femoral condyle corticoperiosteal flap for osteomyelitis of the juxta-articular distal radius: A case report and literature review

“…The MFC corticoperiosteal flap retains the highly osteogenic cambium layer and is preferred for small bone defects such as that observed in the present case [ 6 ]. As shown in Table 1 , 17 cases have been reported in 9 studies in which the MFC corticoperiosteal flap was used for the radius [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ]. The causes included fracture non-union in 15 cases, osteomyelitis in one case, and a bone defect after bone tumour resection in one case.…”