Vascularized Medial Femoral Trochlea Osteocartilaginous Flap Reconstruction of Proximal Pole Scaphoid Nonunions

Descending genicular artery free flaps: Multi-purpose tissue transfers in limb reconstruction

“…Varieties of vascular tissue including skin, 1,6 bone, 3,7e14 cartilage, 15 and composite tissue 2,3,7e9,12,14,16e18 were used for reconstruction in these series (Figure 4). The most common indication is bony nonunion where the medial femoral condyle offers an osteogenic and elastic flap, which readily conforms to the affected site.…”

“…It appears therefore that the DGA free flap offers a wide range of vascular tissue transfers, as also suggested by Burger. 15 However, it has already been pointed out that raising the flap is not always easy because of variations in vascular anatomy. 2 In 50% of one cadaveric study, the SA does not originate from the DGA and it arises directly from the superficial femoral artery, 5 which may impede composite flap elevation.…”

Medial Femoral Condyle Flap

“…Indications for the MFT flap include proximal pole scaphoid nonunions that cannot be reconstructed via conventional techniques and advanced Kienbock disease in young patients. 3,4 …”

Proximal Scaphoid Pole Reconstruction Utilizing Ipsilateral Proximal Hamate Autograft

“…8 Nonunion with or without avascular necrosis (AVN) is a known complication of such fractures with secondary fragmentation of the proximal pole that may in turn render the ability to surgically correct this problem very challenging. 17 Techniques utilizing vascularized 15,18 and nonvascularized bone grafts, 3 rib autografts, 14,18 and free osteochondral grafts 4 have been described with varying success and associated donor site morbidities. One of the limitations of these techniques is how to reconstruct the scapholunate ligament.…”