Free vascularised corticoperiosteal bone flaps in the treatment of non-union of long bones: an ignored opportunity?

Five patients with atrophic or septic non-union of long bones were treated with free vascularised corticoperiosteal bone flaps. The patients had undergone an average of nine prior operations (range, 2-29). The treatment was combined with repeat internal fixation in four patients,. Treatment took place an average of 25.5 months (range 5-83 months) after the initial injury. The thin corticoperiosteal grafts were harvested from the supracondylar region of the femur. One patient died from unrelated causes 2.5 months postoperatively. In the other four patients, bone healing was documented after an average of 7.7 months (range 6-11 months). No further operations were necessary during the follow-up period of 13.7 months on average (range 10-17 months). There were no complications associated with the procedure. The treatment presented here is complex but was successful in this small population. The procedure has the potential to become established as a treatment option for problematic bone defects.