J Reconstr Microsurg 2011; 27(4): 251-260
DOI: 10.1055/s-0031-1275489
© Thieme Medical Publishers

A Composite Osteomusculocutaneous Free Flap from the Medial Femoral Condyle for Reconstruction of Complex Defects

Afshin Rahmanian-Schwarz1 , Vinzent Spetzler1 , Amro Amr1 , Matthias Pfau1 , Hans-Eberhard Schaller1 , Bernhard Hirt2
  • 1Department of Plastic, Reconstructive and Aesthetic Surgery/Burn Center-Tuebingen, BG-Traumacenter, Germany
  • 2Institut of Anatomy, Eberhard Karls University, Tuebingen, Germany
Further Information

Publication History

Publication Date:
18 March 2011 (online)

ABSTRACT

This combined anatomic and clinical study illustrates the first experiences of an osteomyocutaneous flap from the medial femoral condyle for reconstruction of composite tissue defects. We analyzed the anatomic consistency and the vascular distribution of this flap and showed that muscle tissue can easily be added as a composite flap. Twenty-one flaps were harvested from fresh adult cadavers with careful identification of the origin and the course of the three different branches of the descending genicular artery. The corresponding skin areas and muscle portion were identified. The clinical application of this flap was described for closure of complex calcaneal defects. The cadaveric study presented a constant pedicle length and diameter of the arteries, combined with a constant venous drainage. Furthermore, the medial condyle provided a corticocancellous segment and separate vascularity for skin and muscle portions. In the case reports, satisfying results of bone union and soft tissue contouring were achieved. The medial femur condyle region is a reliable donor site for composite flaps, providing a good corticocancellous bony structure and a separate skin paddle, as well as a muscle portion. Its vascular distribution shows anatomic consistency. Despite long-term atrophy of muscle transplants, we believe the additional muscle tissue improves the reconstruction results and provides better soft tissue contouring.

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Afshin Rahmanian-SchwarzM.D. 

BG-Traumacenter Tuebingen, Department of Plastic, Reconstructive and Aesthetic Surgery/Burn Center

Schnarrenbergstraße 95, Tuebingen, Baden Wuertenberg 72076, Germany

Email: a.rahmanian@web.de