Vasculature of a Medial Femoral Condyle Free Flap in Intact and Osteotomized Flaps

Rysz, Maciej; Grabczan, Wojciech; Mazurek, Maciej; Krajewski, Romuald; Grzelecki, Dariusz; Ciszek, Bogdan

doi:10.1097/prs.0000000000003155

Cited by 13 publications

(12 citation statements)

References 36 publications

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“… 1 The DGA pedicle length averages 6.6 cm. 6 , 10 The SGA emerges medially from the popliteal artery to perfuse the medial condyle and consists of a shorter vascular leash of approximately 4.1 cm 1 (Fig. 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…9,10 First performed by Sakai et al in 1991, the MFC flap has since undergone numerous revisions, evolving into a highly adaptable option for cases requiring small amounts of vascularized bone. 1,10,11 MFC flap characteristics can be tailored to the reconstructive task at hand, expanding the possible indications for its use. 1,[10][11][12][13] Earlier variations of the MFC flap focused on harvesting the periosteum and underlying cambium to generate a flexible, osteogenic flap ideal for treating bony nonunion, among other applications.…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

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

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“…Hence, bone flap harvest can be carried out with the least complications. In addition to this large-sized trochlear foramen as seen in our study, furnishing sufficient periosteal blood supply to bone allows adequate corticocancellous bone flap harvest without jeopardizing the nutrition [ 6 ]. The high osteogenic potential of the cambium layer and larger size of vascular foramen make this area an ideal one for preventing bony non-union.…”

Section: Discussionmentioning

confidence: 99%

Morphometry and Morphology of Vascular Foramen on the Trochlear Groove of the Distal Femur and Its Implications

Singh¹

2021

Cureus

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Background and objectiveNutrient foramina in supracondylar, medial condyle, lateral condyle, and intercondylar fossa have been described in the literature. The author of the present study observed a vascular foramen on the trochlear groove, which has not been previously reported in the literature. The aim of the study was to elaborate on the morphology, morphometry, and associated clinical implications of this foramen.

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“…Having a significant number of foramina is advantageous since it ensures that the area is well-supplied, thereby enabling fast curing [ 7 ]. Providing adequate periosteal bloodstream to the bone permits significant corticocancellous bone fold harvest, which will abstain from endangering nutrition, in addition to the enormous trochlear foramen found in our study [ 8 ]. Because of the cambium layer's strong osteogenic potential and the bigger size of the vascular foramen, this location is optimal for avoiding bone non-union.…”

Section: Discussionmentioning

confidence: 99%

Topographic Anatomy and Clinical Impact of Vascular Foramen on the Trochlear Groove of Adult Human Dry Femora

Haris¹,

Baseer²,

Haris³

et al. 2021

Cureus

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Objective In this study, we aimed to assess the topographic anatomy and clinical impact of the vascular foramen on the trochlear groove of adult human dry femora. Materials and methods The incidence, shape, size, and location of the foramen present on the trochlear groove of the distal femur were studied using 33 adult human dry femora of unknown age and gender at the Department of Anatomy at Nowshera Medical College, Nowshera, Pakistan. Using a divider and scale, the incidence and structure of the vascular foramen in the trochlear groove were examined and its position in relation to the trochlear groove's upper and lower articulating edges was recorded. Results Out of 33 femora, 20 (60.6%) were right-sided and 13 (39.4%) were left-sided. All the foramina had round morphometry. In each of the 33 adult human dry femora, 15 (45.5%) had a single trochlear vascular foramen. One solitary trochlear vascular foramen was found in eight (53.3%) of the left femora and seven (46.7%) of the right femora. The diameter of each trochlear vascular foramina was about 2.5-4.5 mm with a mean diameter of 3.5 mm. Trochlear groove upper margin and foramen were 1.75-2.5 cm apart, whereas the lower margin was 0.5-01 cm apart. On average, foramen was 2.2 cm away from the upper margin, and 0.8 cm away from the lower margin. In the midline, nine (60%) trochlear vascular foramina were found, with five (55.5%) resting on the trochlear groove lower margin, and four (44.5%) lying mid-way at varying places from the upper and lower margins. The left of the centerline had six (40%) of the trochlear vascular foramen, whereas no trochlear vascular foramen was seen on the right side of the midline. Conclusions Based on our findings, a significant segment of our population has trochlear vascular foramen present on the trochlear groove as the rate of occurrence of this was found to be 45.5%. The trochlear groove center has the most foramen, accounting for 60% of all the foramen.

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Vasculature of a Medial Femoral Condyle Free Flap in Intact and Osteotomized Flaps

Abstract: A medial femoral condyle corticocancellous bone flap had sufficient blood supply, allowing for harvesting flaps up to 11 cm long, and subperiosteal osteotomy did not compromise the vasculature of the flap's bone.

Cited by 13 publications

References 36 publications

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

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

Morphometry and Morphology of Vascular Foramen on the Trochlear Groove of the Distal Femur and Its Implications

Topographic Anatomy and Clinical Impact of Vascular Foramen on the Trochlear Groove of Adult Human Dry Femora

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