Wu Fei1, Xing Danmou1, Ren Dong1, Feng Wei1, Kyle R Eberlin2, Chen Yan1, Kan Wusheng1. 1. Department of Hand Surgery and Microsurgery, Affiliated Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan City, Hu Bei Province, People's Republic of China. 2. Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: Nonunions in the upper extremity are challenging for the reconstructive surgeon. The evolution of microsurgical techniques has allowed for the reliable use of free vascularized bone flaps. METHODS: In a retrospective study, patients with challenging upper limb nonunions who underwent free vascularized corticocancellous flaps from the medial femoral condyle (MFC) were included. Patient demographics, surgical technique, and outcomes were evaluated. RESULTS: Fifteen patients with nonunions of the upper extremity underwent free MFC corticocancellous flap reconstruction. The length of preoperative bone defects ranged from 0.8 to 3 cm, and the mean number of procedure prior to free MFC reconstruction was 1.5. Thirteen patients healed completely in an average of 15 weeks (range, 8-22 weeks). Two patients were lost to follow-up. Only one patient required additional surgery. Functional outcome measures such as Mayo, Disability of Arm, Shoulder, and Hand, and Constant-Murley scores all demonstrated improvement. CONCLUSION: The free vascularized MFC corticocancellous flap can be successfully used for challenging upper extremity nonunions and small bone defects. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
BACKGROUND: Nonunions in the upper extremity are challenging for the reconstructive surgeon. The evolution of microsurgical techniques has allowed for the reliable use of free vascularized bone flaps. METHODS: In a retrospective study, patients with challenging upper limb nonunions who underwent free vascularized corticocancellous flaps from the medial femoral condyle (MFC) were included. Patient demographics, surgical technique, and outcomes were evaluated. RESULTS: Fifteen patients with nonunions of the upper extremity underwent free MFC corticocancellous flap reconstruction. The length of preoperative bone defects ranged from 0.8 to 3 cm, and the mean number of procedure prior to free MFC reconstruction was 1.5. Thirteen patients healed completely in an average of 15 weeks (range, 8-22 weeks). Two patients were lost to follow-up. Only one patient required additional surgery. Functional outcome measures such as Mayo, Disability of Arm, Shoulder, and Hand, and Constant-Murley scores all demonstrated improvement. CONCLUSION: The free vascularized MFC corticocancellous flap can be successfully used for challenging upper extremity nonunions and small bone defects. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.