Medial femoral condyle free flap—cadaveric study of anatomical limits

Introduction: The Medial Femoral Condyle Flap (MFC) is a cortico perisoteal flap used for recalcitrant non-unions and facial reconstruction. Evaluation of MFC modelling will allow more accurate reconstruction in head and neck region.

Aim: To evaluate the anatomical limits of blood supply for the osteotomy modelling of MFC flap.

Materials and methods: There have been 16 specimens collected from cadavers aged 27–91 (median 54, SD: 15.5) years old, 5 females and 11 males, 8 right and 8 left limbs. Fresh cadaveric limbs were dissected with the surgical approach through curvilinear incision of skin made on the medial aspect of the thigh. Flap was raised by oscillating saw and chisel. Vessel of fistula was dissected microscopically, with 12.5 magnification and then cannulated after osteotomies by 17G catheter. Using manual pressure fistula was perfused with 50 cc of red latex. Flaps perfusion was evaluated by the blood supply to distal corners (present or absent). Material was divided into 2 groups: with osteotomy (9 cases) and without osteotomy (7 cases). Results: Flaps sizes: length 7–12 cm (mean 9.1, SD: 1.4), height 0.6–4 cm (mean 2.3, SD: 0.8), width 0.4–3 (mean 1.2, SD: 0.75), fistula 3.5–8.6 cm (mean 6.65, SD: 1.6), mean arterial diameter 2.56 mm, mean venal diameter 1.75 mm. Absence of perfusion in more than one flap corner was observed in 2/7 cases in non-osteotomy group and in 1/9 cases in osteotomy group. Conclusions: MFC flap can serve as accessory bony flap for head and neck reconstructions. Observations from our cadaveric study, revealed that vascular web of these flap provide adequate blood supply for modelling by osteotomy. Further clinical trials need to be done.

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Medial femoral condyle free flap—cadaveric study of anatomical limits

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