gms | German Medical Science

Objectives/Interrogation: The use of the medial femoral condyle free flap (MFCF) is a versatile option for the treatment of upper extremity nonunions 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 non-unions that have failed three or more treatments to obtain consolidation

Methods: 6 patient in total were included in this report, 3 scaphoid fracture, two non unions and one avascular necrosis of the proximal pole, a recalcitrant non union of the distal humerus, non union of a wrist fusion secondary to distal radius excision resulting from Giant Cell Tumor and a thumb distal phalange reconstruction. Age range 37 year old (22-59), 2 females, 4 males, 3 right upper limbs and 3 left upper limbs, 3 right knee donor side and 3 left knee donor side, all patient underwent prior surgery before the MFCF, none of the patient were Smokers, Diabetes was present in the patient with distal humerus fracture and the Giant Cell Tumor.

Results and Conclusions: In conclusion, the utility of the MFCF is immeasurably varied, achieving a 100% consolidation in all our cases. The MFCF graft can also be used to manage large bone defects, recalcitrant non unions, bone reconstructions, and management of scaphoid fracture. Achieving complete consolidation with good vascularity gives the patient the best chance of avoiding the development of debilitating osteoarthritis of the wrist joint. The consistent anatomy in the knee makes the MFCF graft easily identifiable, resulting in lower morbidity in the donor area. For these reasons, the authors consider the MFCF flap an excellent treatment option in the arsenal of methods treat non unions with low vascularity.