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

Rysz, Maciej M.D., D.D.S., Ph.D.; Grabczan, Wojciech M.D.; Mazurek, Maciej Jan M.D.; Krajewski, Romuald M.D., Ph.D.; Grzelecki, Dariusz M.D.; Ciszek, Bogdan M.D., Ph.D.

Plastic and Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 992–997
doi: 10.1097/PRS.0000000000003155
Reconstructive: Head and Neck: Original Articles
Coding Perspective

Background: A small size and difficulties with shaping a medial femoral condyle corticocancellous bone flap are factors limiting its use. The goal of this study was to evaluate range of vascular supply to a medial femoral condyle corticocancellous bone flap to determine whether harvesting of larger flaps and performing a flap osteotomy would compromise the vasculature of a flap’s bone.

Methods: Twenty-four limbs were dissected and medial femoral condyle corticocancellous bone flaps were harvested with skin paddles. Thirteen of 24 flaps had subperiosteal osteotomies simulating shaping a bone for reconstruction. A pedicle artery was perfused with red latex. Medial femoral condyle corticocancellous bone flap vascularization was evaluated by cutting the bone into 1-cm blocks and assessing the number of Haversian canals filled with red latex.

Results: Length of harvested flaps was 7 to 13 cm, thickness was 0.5 to 3 cm, and width was 1 to 3 cm. Pedicle length was between 3.5 and 9 cm (mean ± SD, 6.6 ± 1.6 cm). Red latex filled bone vessels at a distance of 6 to 11.5 cm from the distal end of a flap (8.2 ± 1.4 cm). Skin paddles were filled with latex in all cases.

Conclusion: 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.

Coding Perspective for this Article is on Page 996.

Warsaw, Poland

From the Head and Neck Cancer Department, Memorial Cancer Center Institute of Oncology; and the Department of Descriptive and Clinical Anatomy, Warsaw Medical University.

Received for publication January 1, 2016; accepted November 4, 2016.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Maciej Rysz, M.D., D.D.S., Ph.D., Roentgena 5 Street, 02-781 Warsaw, Poland, riisz@wp.pl

©2017American Society of Plastic Surgeons