Free composite medial femoral trochlea osteochondral cutaneous flap for wrist scaphoid and lunate cartilage lesions: Advantages of a skin paddle

Aribert, M.; Corcella, D.; Bouyer, M.

doi:10.1016/j.hansur.2019.05.002

Cited by 4 publications

(4 citation statements)

References 36 publications

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“…This finding was confirmed in our patients, with adequate vessels in all cases. We could demonstrate comparable results with MFT in bony healing rates, ROM and also in the possibility of halting deterioration in Lichtman stage or even to reversing it (Aribert et al., 2019, Bürger et al., 2014, Pet et al., 2020).…”

Section: Discussionmentioning

confidence: 58%

“…The medial condyle of the femur is a versatile surgical donor site. It is possible to harvest corticocancellous bone grafts as well as osteochondral grafts with adequate vascularity (Aribert et al, 2019;Bu ¨rger et al, 2013Bu ¨rger et al, , 2014Frangen et al, 2012;Higgins et al, 2018;Wong et al, 2015). Investigations of the vascular supply of the lateral femoral condyle have shown a dependable vascularization by the SLGA comparable with that of the medial condyle and which allows reliable use of the LFT (Morsy et al, 2018;Parvizi et al, 2016;Wong et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…The reconstruction of lunates with Lichtman Grade III Kienbo ¨ck's disease with damaged cartilage on the radiolunate surface has up to now only been possible using osteochondral grafts from the medial femoral trochlea (MFT). Satisfactory mid-term results have been published in recent years (Aribert et al, 2019;Bu ¨rger et al, 2014;Frangen et al, 2012;Gillis and Higgins, 2018;Pet et al, 2020). This procedure allows reconstruction of the destroyed proximal joint surface of the semilunar bone with restoration of carpal height and revascularization of the lunate.…”

Section: Introductionmentioning

confidence: 99%

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The free vascularized lateral femoral trochlea osteochondral graft: a reliable alternative for Stage III Kienböck’s disease

Windhofer

Anoshina²,

Ivusits

et al. 2021

J Hand Surg Eur Vol

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Lunate reconstruction using a lateral femoral trochlea osteochondral graft was carried out in 27 patients with Stage III Kienböck’s disease from 2012 to 2019. Twenty-three of these patients could be followed-up in this retrospective study. Ten were women and 13 men. Nine were Lichtman Stage IIIA, seven Stage IIIB and seven Stage IIIC. The mean follow-up was 39 months (range 12–86). Bony consolidation was found in 18 of the 23 patients, with no graft loss. The mean Disabilities of the Arm, Shoulder and Hand score (DASH score) was 11 and the Modified Mayo Wrist Score was 83. There were only two radiological deteriorations, with the same or improved Lichtman classifications in the other patients and a significant reduction in pain. Postoperative extension of the wrist (52°) and flexion (48°) were comparable with preoperative values and, respectively, 81% and 72% of the contralateral side. Grip strength and pinch grip were 32 kg and 12 kg, 88% and 94% of the other hand, respectively, and an insignificant increase compared with the preoperative values. The vascularized lateral femoral trochlea osteochondral graft yields good short- and mid-term results in Grade III Kienböck’s disease. Level of evidence: IV

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The free vascularized lateral femoral trochlea osteochondral graft: a reliable alternative for Stage III Kienböck’s disease

Windhofer

Anoshina²,

Ivusits

et al. 2021

J Hand Surg Eur Vol

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“…The medial (and the lateral) femur condyle can be harvested as a chimeric flap including skin, but the skin flap might be very bulky, and the lateral femur condyle has a very short and small feeding artery (Aribert et al, 2019; Gaggl et al, 2008; Hsu et al, 2018; Mehta et al, 2021; Pelzer et al, 2010). Furthermore, the skin of the thigh is not pliable, especially in Caucasians (Acland et al, 1981; Karamursel & Celebioglu, 2006).…”

Section: Discussionmentioning

confidence: 99%

Complex reconstruction of the clavicle with a prefabricated medial femur condyle chimeric flap including a superficial circumflex iliac artery perforator flap: A case report

Giesen,

Costa,

Fritsche

2023

Microsurgery

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The medial femur condyle (MFC) cortico‐periosteal flap is a popular flap for bone reconstruction. The use of a chimeric version of this flap with a skin island has been described, but anatomical arterial variation can occur that prevent its harvest. Furthermore, the donor area of the skin paddle has been debated as poor because of the scarring in a visible area and because of the difficulty in obtaining pliable thin skin. We present a fabricated chimeric MFC cortico‐periosteal flap joined with a superficial inferior epigastric perforator (SCIP) flap to reconstruct and augment a sclerotic and insufficient small clavicula with the skin paddle acting as a monitor and as a substitute for the overlying skin. A 52‐year‐old female patient had a history of multiple refractures of the right hypoplastic clavicle with a diameter of 7 mm, resulting in a sclerotic bone with a fibrotic scar. The reconstruction was done in one surgical session using a cortico‐periosteal flap from the left medial condyle and a thin SCIP flap from the left groin. The area of the clavicle to be reconstructed was 3 cm, and the direct overlying skin (approximately 6 × 3 cm) was severely scarred and painful. The MFC flap was 5 × 4 cm, while the SCIP flap was 7 × 3.5 cm. The SCIP flap artery was anastomosed on the table end‐to‐side to the descending genicular (DG) artery of the MFC, and the vein was anastomosed end‐to‐end to a comitans vein of the DG artery. The flap fully survived after an initial congestion. At 12 months, we observed a satisfactory reconstruction of the clavicle with an enhanced diameter of 12 mm. The patient recovered full function of the shoulder with no pain. Using a fabricated chimeric flap composed of a medial femoral condyle and a superficial circumflex artery perforator flap may be an additional option for tailored reconstruction of complex osteo‐cutaneous defect of clavicle.

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Lateral Femoral Trochlea Osteochondral Flap Reconstruction of Proximal Pole Scaphoid Nonunions

Windhofer¹,

Higgins²,

Gaggl³

et al. 2024

The Journal of Hand Surgery

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Free composite medial femoral trochlea osteochondral cutaneous flap for wrist scaphoid and lunate cartilage lesions: Advantages of a skin paddle

Cited by 4 publications

References 36 publications

The free vascularized lateral femoral trochlea osteochondral graft: a reliable alternative for Stage III Kienböck’s disease

The free vascularized lateral femoral trochlea osteochondral graft: a reliable alternative for Stage III Kienböck’s disease

Complex reconstruction of the clavicle with a prefabricated medial femur condyle chimeric flap including a superficial circumflex iliac artery perforator flap: A case report

Lateral Femoral Trochlea Osteochondral Flap Reconstruction of Proximal Pole Scaphoid Nonunions

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