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Utility and Versatility of Medial Femoral Condyle Flap for Upper Extremity Non-Union
Barkat Ali
Michelle Palazzo
Rodrigo Moreno
Christine M Kleinert Institute
2022-01-28
Presenter: Barkat Ali
Affidavit:
The abstract has been reviewed by all authors
Director Name: Michelle Palazzo
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Introduction
Non-union in the upper extremity is a debilitating condition for the patient. The management involves use of bone grafts. A variety of options are available from non-vascularized to vascularized and from local pedicled flaps to distant free flaps. Medial Femoral Condyle (MFC) is a vascularized free osteocutaneous flap which offers redeeming solution. We describe our experience with the use of this flap in the management of non-union in the upper extremity.
Methods
A retrospective study was conducted from a single institution. Consecutive patients undergoing MFC by a single surgeon over the last decade were included. All the patients were adults. Medical records were reviewed for patient demographic information, operative details, radiographic features, and functional outcomes.
Results
Twelve patients met inclusion criteria. Nine flaps were done for scaphoid non-unions, while one for distal humerus, distal radius, and distal phalanx of thumb each. Procedural successes were noted to be 100%. Bone healing was found to be 83.3%. Functional outcomes i.e., VAS reduced from 7.1± 2.2 to 2 ± 1.9, p <0.01 and Mayo wrist scores improved from 50.7 ± 14.3 to 75.7 ± 13.05, p <0.01. While wrist range of motion, grip strength and return to full activity did no achieve statistical significance. Patient satisfaction scores after the procedure were 8.7 ± 1.5 range (6-10).
Conclusions
MFC flap is an excellent option in the management of non-union of upper extremity. Its application across different anatomic regions adds to its versatility. We report excellent functional outcomes with the use of this flap.
