Abstract
Background
Medial femoral condyle(MFC) flap is frequently used in hand reconstruction, but like
other buried flaps, MFC is not easy to monitor and follow.In this study, we present
our adipofascial and periosteal tissue technical modifications and results for MFC
free flap monitoring and compare different monitoring methods.
Methods
Twenty one patients with wrist bone or metacarpal defect reconstructed with MFC flap
were included in the study. Adipofascial tissue in wrist defect and periosteal tissue
in metacarpal defect were selected as MFC flap's monitor. Patient characteristics,
type of injury, flap size, early or late-period complications, flap elevation time,satisfaction
scale, visual analogue scale (VAS) and postoperative X-ray view were noted.
Results
There were 3 female and 18 male patients in the study. The mean age of the patients
was 50.8 (38–68). The elevation times of flaps with adipofascial and periosteal monitors
were 48 and 53.3 min, respectively. The satisfaction scale averages for the adipofascial
and periosteal monitor groups were 3.5 and 3.54, respectively. The VAS scores of the
adipofascial and periosteal monitor groups were 2.9 and 3.9, respectively. The flap
sizes with periosteal and adipofascial monitors were 10.48 cm3 and 1.36 cm3, respectively. There was no statistically significant difference between flap elevation,
VAS, and satisfaction scale (>0.05). There was a statistically significant difference
in flap sizes. (<0.05)
Conclusion
MFC free flap is frequently used in wrist and metacarpal reconstruction. Monitor selection
according to the defect area positively affects the prognosis of the flap in the postoperative
period.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Chimeric medial femoral condyle osteocutaneous flap for reconstruction of multiple metacarpal defects.J Hand Surg Am. 2018; 43 (e1-. e9): 781
- Metacarpal reconstruction with a medial femoral condyle flap based on a 3D-printed model: a case report.Case Rep Plastic Surg Hand Surg. 2022; 9: 52-56
- Evaluation of the implantable Doppler probe for free flap monitoring in lower limb reconstruction.J Reconstr Microsurg. 2018; 34: 218-226
- Refinements of the medial femoral condyle bone flap for finger reconstruction.Orthoplastic Surgery. 2021; 3: 26-29
- Versatility of the medial femoral condyle flap for extremity reconstruction and identification of risk factors for nonunion, delayed time to union, and complications.Ann Plast Surg. 2018; 80: 364-372
- Vascularized medial femoral trochlea osteochondral flap reconstruction of advanced Kienböck disease.J Hand Surg Am. 2014; 39: 1313-1322
- Free vascularized thin corticoperiosteal graft.Plast Reconstr Surg. 1991; 87: 290-298
- The arterial anatomy of the medial femoral condyle and its clinical implications.J Hand Surg (European Volume). 2010; 35: 569-574
- Mandibular reconstruction using a free vascularised osteocutaneous flap from the internal condyle of the femur.Br J Plast Surg. 1991; 44: 397-402
- The reconstructive ladder: an orthoplastic approach.Orthop Clin North Am. 1993; 24: 393-409
- Effects of a formalized collaboration between plastic and orthopedic surgeons in severe extremity trauma patients; a retrospective study.J Trauma Manag Outcomes. 2015; 9: 1-8
- Free medial femoral condyle bone grafting for scaphoid nonunions with humpback deformity and proximal pole avascular necrosis.Tech Hand Up Extrem Surg. 2007; 11: 246-258
- Free vascularized medial femoral condyle autograft for challenging upper extremity nonunions.Hand Clin. 2012; 28: 493-501
- Arterial anatomy of the free vascularised corticoperiosteal graft from the medial femoral condyle.Acta Orthop Belg. 2011; 77: 502
- Donor-site morbidity and functional status following medial femoral condyle flap harvest.Plast Reconstr Surg. 2018; 142 (734e-41e)
- Surgical treatment of neuromas improves patient-reported pain, depression, and quality of life.Plast Reconstr Surg. 2017; 139: 407-418
- Matriderm and platelet-rich plasma combination in the treatment of recurrent carpal tunnel syndrome: a new approach.Eur J Plast Surg. 2022; 45: 299-306
- The vascularized medial femoral corticoperiosteal flap for reconstruction of bony defects within the upper and lower extremities.Seminars Plastic Surg: © Thieme Medical Publishers. 2008; : 228-233
- Vascularized medial femoral condyle bone graft for resistant nonunion of the distal radius.J Hand Surg (Asian-Pacific Volume). 2017; 22: 23-28
Article info
Publication history
Published online: September 20, 2022
Accepted:
September 19,
2022
Footnotes
✰- This article has never been presented at any meetings.
✰✰No funding.
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.