Wrist arthrodesis with the medial femoral condyle flap: Outcomes of vascularized bone grafting for osteomyelitis

Microsurgery ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 32-38 ◽  
Author(s):  
David Mattos ◽  
Jason H. Ko ◽  
Matthew L. Iorio
Keyword(s):  
Bone Grafting ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Wrist Arthrodesis ◽  
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.

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

The Anterolateral Thigh-Medial Femoral Condyle Chimeric Flow-through Flap for Posttraumatic Wrist Arthrodesis

2019 ◽  
Vol 23 (3) ◽  
pp. 143-145
Author(s):  
David E. Kurlander ◽  
Yuewei Wu-Fienberg ◽  
Tobias C. Long ◽  
David J. Rowe ◽  
James Gatherwright
Keyword(s):  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Wrist Arthrodesis ◽  
Anterolateral Thigh ◽  
Flow Through

scholarly journals Medial Femoral Condyle Flap Reconstruction of a Maxillary Defect with a 3D Printing Template

2017 ◽  
Vol 02 (01) ◽  
pp. e63-e68
Author(s):  
Erin Taylor ◽  
Winona Wu ◽  
Parisa Kamali ◽  
Nalton Ferraro ◽  
Joseph Upton ◽  
...  
Keyword(s):  
3D Printing ◽  
Femoral Condyle ◽  
Three Dimensional ◽  
Medial Femoral Condyle ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Maxillary Defect ◽  
3D Ct Scan ◽  
Genicular Artery ◽  
Vascularized Bone

Background The medial femoral condyle (MFC) flap is a well-vascularized corticocancellous flap based off the descending genicular artery that can be used to reconstruct difficult bony nonunions. Although frequently used in reconstruction of extremity defects, the MFC flap is rarely used in maxillofacial reconstruction. Methods We present a case example of an MFC vascularized corticocancellous free flap for reconstruction of an ameloblastoma maxillary defect. Additionally, we describe our use of a three-dimensional (3D) template to create an intraoperative osteotomy model for contouring the MFC flap. Results Preoperative 3D printing of the maxillary defect and design of a methylmethacrylate template enabled the precise and rapid contouring of a well-vascularized bone flap. Postoperative 3D CT scan demonstrated satisfactory positioning of the MFC flap within the maxilla. Conclusion The 3D printing technology continues to advance craniofacial reconstruction and allows for the efficient and precise creation of vascularized bone flaps. The MFC vascularized flap has the potential of becoming a workhorse flap in maxillary defect reconstruction alongside the use of 3D printing technology.

Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis

2018 ◽  
Vol 44 (6) ◽  
pp. 600-606 ◽  
Author(s):  
Kathleen M. Kollitz ◽  
Nicholas Pulos ◽  
Allen T. Bishop ◽  
Alexander Y. Shin
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Femoral Condyle ◽  
Primary Treatment ◽  
Medial Femoral Condyle ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Carpal Collapse ◽  
Time From Injury ◽  
Vascularized Bone

This study aimed to determine the outcome of free vascularized medial femoral condyle bone grafts in the primary treatment of scaphoid nonunions with scaphoid foreshortening or carpal collapse and intraoperatively documented avascular necrosis. Thirty-two patients (28 male, four female) met the inclusion criteria. Median time from injury to surgery was 70 weeks. Thirty of 32 patients healed at a median of 12 weeks. There was significant improvement from preoperative to postoperative lateral intrascaphoid angle, scapholunate angle, and radiolunate angle. Two scaphoids failed to unite; one patient underwent scaphoidectomy and four-corner fusion 15 months postoperatively after suffering a subsequent injury. Another patient underwent 1,2-intercompartmental supraretinacular artery-based vascularized bone grafting at 4 months postoperatively and then scaphoid excision with four-corner fusion 4 years later. The free vascularized medial femoral condyle bone graft restores scaphoid vascularity and architecture while promoting union in a subset of scaphoid nonunions that has historically been a clinical challenge. Level of evidence: IV

Surgical Solution for Total Carpectomy due to Destructive Wrist Pan-Osteomyelitis Using a Free Femoral Condyle Osteocutaneous Flap for Wrist Arthrodesis

2021 ◽  
Author(s):  
Francisco Guillermo Castillo-Vázquez ◽  
Ignacio Palafox-Carral ◽  
Ranulfo Romo-Rodríguez ◽  
Marisol Limón-Muñoz ◽  
Efraín Farías-Cisneros
Keyword(s):  
Femoral Condyle ◽  
Fold Increase ◽  
Carpal Bones ◽  
Medial Femoral Condyle ◽  
Necrotic Bone ◽  
Wrist Arthrodesis ◽  
Immunosuppressive Medications ◽  
Definitive Solution ◽  
Osteocutaneous Flap ◽  
Acute Event

AbstractOsteomyelitis of the hand is rare, even more so in the carpal bones. Patients with rheumatoid arthritis (RA) have a higher infection rate overall, and up to a 14-fold increase in the incidence of septic arthritis of the hand. The destruction of immunologic barriers, such as cartilage and joint capsules, as well as the use of immunosuppressive medications will have an impact on the higher incidence of articular infections and osteomyelitis in these patients. Infection in these cases is often overlooked because of the similarity of presentation to an acute event of RA. When osteomyelitis is present, rapid and aggressive treatment should be given. Surgical debridement, lavage, and excision of necrotic bone is the best choice, followed by cemented antibiotic impregnated spacer to resolve the acute scenario. Vascularized bone grafts (VBG) can then be used for a definitive solution, as these have great biologic properties that increase the possibility of a good outcome. We hereby present a report of a wrist arthrodesis, using a free medial femoral condyle VBG for the treatment of destructive osteomyelitis of the carpal bones in a female patient with RA.

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