<scp>U</scp>pper and lower extremity reconstructive applications utilizing free flaps from the medial genicular arterial system: A systematic review

Kazmers, Nikolas H.; Thibaudeau, Stéphanie; Steinberger, Zvi; Levin, L. Scott

doi:10.1002/micr.30138

Cited by 17 publications

(21 citation statements)

References 51 publications

(145 reference statements)

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“…Recent literature reports eight thumb reconstructions using the MFCF demonstrating the versatility and reliability of this flap. 18 On the distal humerus fracture, final DASH score of 0.8 demonstrates good outcomes compared with the literature (27.8), however, we are aware that this is only one case and further patients would need to be evaluated to confirm this result. Our time for consolidation after the MFCF was similar to previously published averages.…”

Section: Discussionmentioning

confidence: 67%

The medial femoral condyle free flap: An excellent option for difficult cases: case series

Quintero

Childs

Moreno

2020

SAGE Open Medical Case Reports

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The use of the medial femoral condyle free flap is a versatile option for the treatment of upper extremity non unions and reconstructive procedures associated with bone loss or osteonecrosis. The benefit of this type of flap is the viability of the bone which favors primary ossification and increases bone density. Vascularized free bone flaps are especially useful for the treatment of recalcitrant nonunions, or nonunions that have failed three or more treatments to obtain consolidation. We present a case series of three patients treated with medial femoral condyle free flap for reconstruction of the upper extremity of different etiologies at the level of the distal humerus, distal radius and distal phalanx of the thumb.

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Section: Discussionmentioning

confidence: 67%

The medial femoral condyle free flap: An excellent option for difficult cases: case series

Quintero

Childs

Moreno

2020

SAGE Open Medical Case Reports

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“…Some studies showed higher complication rates (17.1% vs. 6.2%) in the lower extremities than in the upper extremities [ 38 ]. This finding could not be confirmed in our study.…”

Section: Discussionmentioning

confidence: 99%

A retrospective evaluation of 182 free flaps in extremity reconstruction and review of the literature

Arakelyan¹,

Aydogan²,

Spindler³

et al. 2022

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Introduction : During the past decades, free flaps have been given a central role in the reconstructive surgery. Especially in the extremities, where there is a scarcity of available tissues for local flaps, free flaps play a central part. The aim of this study was to evaluate the risk factors contributing to partial and total flap failure. Patients and methods : In a retrospective cohort study, all data concerning patients who underwent free flap reconstruction of the extremities during the first five years since the founding of the department of plastic surgery were gathered. Patient- and surgery-related risk factors were analyzed in correlation to the postoperative complications. Results : In total, 182 free flaps were included in this study. Partial and total flap failure were noted in 21.42% and 17.03%, respectively. A correlation was seen between the time lapsed from debridement until flap coverage, with flaps performed between day 4 and 14 having the least quote of flap failure (p=0.022). Gender, age, arterial hypertension, nicotine abuse, diabetes mellitus, peripheral arterial disease and the number of anastomosed veins were not significantly associated with free flap failure. Conclusion : Our study showed that free flaps can be safely performed in healthy patients as well as in patients with risk factors, with an acceptable flap loss rate. Randomized controlled studies are needed to clarify the exact role of each risk factor in free flap surgery.

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“…21 Regarding MFC donor-site morbidity, Rodríguez-Vegas and Delgado-Serrano 22 reported a series of 25 patients wherein they had few transient donor-site complications, including suture intolerance, seroma, and numbness in the saphenous territory; no fracture, knee instability, or stiffness was reported. Moreover, Kazmers et al 23 performed a systematic review of 40 papers which showed that the knee donor site rate of complications was 0.8% for femoral fracture and 0.4% for persistent knee pain. As for a femoral fracture, potentially the most serious complication, two studies conducted by the same group have shown the following: first, that harvest of MFC flap sizes greater or equal than 9 cm results in significantly lower stiffness compared with the 3-cm flap while testing axial stability, however, the femur retains its axial stability even after harvest of large corticocancellous flaps from its medial aspect 24 ; on the other hand, Endara et al 25 showed that bone failure rates were 12.5, 12.5, 28.6, and 55.6% for control, 3-, 5-, and 7-cm MFC harvest size groups, respectively.…”

Section: Discussionmentioning

confidence: 99%

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

Castillo-Vázquez

Palafox-Carral

Romo-Rodríguez

et al. 2022

Journal of Hand and Microsurgery

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Osteomyelitis 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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Upper and lower extremity reconstructive applications utilizing free flaps from the medial genicular arterial system: A systematic review

Cited by 17 publications

References 51 publications

The medial femoral condyle free flap: An excellent option for difficult cases: case series

The medial femoral condyle free flap: An excellent option for difficult cases: case series

A retrospective evaluation of 182 free flaps in extremity reconstruction and review of the literature

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

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