Background: The medial femoral condyle has become a reliable source of vascularized bone with many advantages to the reconstructive microsurgeon. The authors examined the donor-site morbidity of medial femoral condyle flap harvest.
Methods: A retrospective review of all patients who underwent medial femoral condyle free flap procedures between April of 2009 and December of 2010 was conducted. Study participants underwent computed tomographic scans of their bilateral distal femurs and knee joints to evaluate the donor site and examine differences between the operated and nonoperated sides.
Results: Fifteen patients underwent medial femoral condyle free flap procedures. Ten of them agreed to participate in the study. The average time between surgery and computed tomographic scans was 18.0 months (range, 12.2 to 30.4 months). Average bone harvested per procedure was 16.1 cm3 (range, 2 to 34 cm3), representing an average condylar volume of 9 percent (range, 1 to 18 percent). Reparative bone formation was minimal, with an average thickness of 4.5 mm (range, 4 to 6 mm). There were no findings of new degenerative joint disease on computed tomographic scans resulting from medial femoral condyle harvest. The flap success rate was 100 percent (10 of 10) for patency and achieving osseous union. There were no major or flap-related complications. Two patients reported numbness of the donor site at long-term follow-up (average, 17.5 months; range, 12.2 to 30.4 months).
Conclusions: Medial femoral condyle harvest creates minimal donor-site morbidity according to radiographic measures at more than 1-year follow-up. Surgeons can anticipate minimal unassisted bone regeneration at the donor site at this time interval.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
From The Curtis National Hand Center, MedStar Union Memorial Hospital.
Received for publication July 11, 2012; accepted September 26, 2012.
Disclosure: The authors have no financial interest relating to this work. The authors have no commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article.
James P. Higgins, M.D.; c/o Anne Mattson, 3333 North Calvert Street, Suite 200, The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, Md. 20218, firstname.lastname@example.org