scholarly journals Vascularized bone grafts from the distal third of the femur. Present state of the matter

2018 ◽  
Vol 25 (1) ◽  
pp. 66-71
Author(s):  
Il’ya A. Kukin ◽  
I. O Golubev
Keyword(s):  
Present State ◽  
Femoral Condyle ◽  
Donor Site ◽  
Bone Grafts ◽  
Lateral Femoral Condyle ◽  
Common Variants ◽  
Vascularized Bone

The basic types of the medial and lateral femoral condyle grafts are considered. The most common variants of these grafts application and the donor site complications are presented. Peculiarities of femoral distal third vascular topography and their frequency obtained in the course of anatomic studied.

Donor site morbidity of vascularized bone grafts from the medial femoral condyle for osseous revascularization

Microsurgery ◽  
2020 ◽  
Vol 40 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Victoria Franziska Struckmann ◽  
Giuseppe Rusignuolo ◽  
Leila Harhaus ◽  
Ursula Trinler ◽  
Berthold Bickert ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Donor Site ◽  
Bone Grafts ◽  
Donor Site Morbidity ◽  
Medial Femoral Condyle ◽  
Vascularized Bone

scholarly journals Medial Femoral Condyle Free Flap Reconstruction of Complex Foot and Ankle Pathology

2019 ◽  
Vol 4 (4) ◽  
pp. 247301141988426 ◽  
Author(s):  
John T. Stranix ◽  
Merisa L. Piper ◽  
Said C. Azoury ◽  
Geoffrey Kozak ◽  
Oded Ben-Amotz ◽  
...  
Keyword(s):  
Free Flap ◽  
Femoral Condyle ◽  
Donor Site ◽  
Case Series ◽  
Medial Femoral Condyle ◽  
Flap Reconstruction ◽  
Foot And Ankle ◽  
Osseous Union ◽  
Vascularized Bone

Background: Complex hindfoot pathology may benefit from vascularized bone flap reconstruction rather than traditional bone grafting techniques. Medial femoral condyle (MFC) flaps provide vascularized periosteum, skin, and corticocancellous bone. Methods: A retrospective, single-institution cohort study of consecutive MFC flaps performed for complicated hindfoot reconstruction between 2013 and 2019 was reviewed. Radiologic follow-up assessed osseous union and clinical outcomes were evaluated with the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. Thirty MFC flaps were performed in 28 patients for complex hindfoot pathology. Twenty-seven flaps had adequate clinical and radiographic follow-up (mean 15.8 months). Results: The majority presented with avascular necrosis (83%) and failed prior operations (67%, mean 3.1). Most hindfoot procedures involved arthrodesis (n = 24, 80%); tibiotalocalcaneal (n = 11) and talonavicular (n = 7) most frequently. Mean osseous flap volume was 10.3 cm3 (range 1.7-18.4 cm3); one flap required takeback for venous congestion but no total flap losses occurred. Primary osseous union was initially achieved in 20 patients (74%, mean 217 days). Six flaps developed interface nonunion; 5 underwent revision arthrodesis and ultimately achieved union in 24/27 flaps (89%, mean 271 days). Risk factors for nonunion were body mass index (BMI) >30 ( P = .017) and prior arthrodesis ( P = .042). Mean AOFAS hindfoot scores increased significantly from 52.3 preoperatively to 70.7 postoperatively ( P < .001). Subscore analysis demonstrated significant improvement in postoperative pain scores from 14.2 to 27.3 out of 40 ( P < .001). Conclusion: The MFC free flap provided vascularized bone for complicated foot and ankle reconstruction with relatively low donor site morbidity, promising osseous union results, and improved functional outcomes. Level of Evidence: Level IV, retrospective case series.

scholarly journals Scaphoid Nonunion With Poor Prognostic Factors

Hand ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Tahseen Chaudhry ◽  
Lauren Uppal ◽  
Dominic Power ◽  
Michael Craigen ◽  
Simon Tan
Keyword(s):  
Prognostic Factors ◽  
Bone Graft ◽  
Femoral Condyle ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Vascularized Bone Graft ◽  
Union Rate ◽  
Poor Prognostic Factor ◽  
Low Incidence ◽  
Vascularized Bone

Background: To report on the results of free medial femoral condyle (MFC) vascularized bone graft for scaphoid nonunions with 1 or more poor prognostic factors. Methods: We have used the free MFC vascularized bone graft for scaphoid nonunions that have 1 or more factors associated with a poor prognosis. These were, a delay in presentation of over 5 years, a proximal pole nonunion, the presence of avascular necrosis (AVN), or previous nonunion surgery. We used this technique on 20 patients over a 4.5-year period. Results: Our overall union rate was 88.5% (17 of 19 patients), with 1 patient failing to attend for follow-up. Our mean union time was 7 months (2-18). All patients had at least 1 poor prognostic factor and over half had 2 or more. Of those with AVN with or without other factors, the union rate was 85% (11 of 13). There were 2 donor site complications that required a further procedure and 2 patients with residual wrist pain that required a scapho-trapezio-trapezoid joint fusion and a radial styloidectomy, respectively. Both nonunions were offered further surgery, and 1 elected to undergo successful revision surgery. Conclusions: Overall, this technique showed good results, in a subgroup of patients that typically have poorer outcomes, with a low incidence of donor site morbidity. Our union rate compares favorably with other techniques for this difficult subset of patients with 1 or more poor prognostic factors, although results are clearly not as good as those of studies using the MFC graft for all scaphoid nonunions. We continue to reserve this technique for nonunions with 1 or more poor prognostic factors, and we believe that this technique should at least be considered in these patients.

Lateral Femoral Condyle Flap: An Alternative Source of Vascularized Bone From the Distal Femur

2015 ◽  
Vol 40 (10) ◽  
pp. 1972-1980 ◽  
Author(s):  
Victor W. Wong ◽  
Heinz K. Bürger ◽  
Matthew L. Iorio ◽  
James P. Higgins
Keyword(s):  
Distal Femur ◽  
Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Alternative Source ◽  
Vascularized Bone

scholarly journals Vascularized bone grafts for post-traumatic defects in the upper extremity

2021 ◽  
Vol 48 (1) ◽  
pp. 84-90
Author(s):  
Giovanna Petrella ◽  
Daniele Tosi ◽  
Filippo Pantaleoni ◽  
Roberto Adani
Keyword(s):  
Upper Extremity ◽  
Bone Grafting ◽  
Femoral Condyle ◽  
Bone Grafts ◽  
Bone Defects ◽  
Tissue Loss ◽  
Surgical Reconstruction ◽  
Non Union ◽  
Post Traumatic ◽  
Vascularized Bone

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5–6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

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