Bone flaps

Question 1

describe medial femoral condyle flap

Answer 1

• use: scaphoid non-union, avascular proximal pole
• vessel: descending genicular (branch of superficial femoral); D 1-2mm; L ~ 7cm
  
  • 1-2VC, similar
• nerve: none
• incision: proximally from medial femoral condyle along posterior border of axis of femur
• dissect through fat and retract greater saphenous infeirorly
• incise investing fascia, retract v. medialus superiorly and gracilis inferiorly
• add. magnus on “floor” of dissection
• identify genicular vessels along surface of femur, follow to condyle
• clear condyle of muscle-fascia attachments
• incise periosteum, incise cortex using oscillating saw (size 2.5 x 1.5 cm), raise bone flap using osteotome
• follow vessel proximally to source, maybe thru adductor hiatus

Question 2

What are indications for a Vascularized Bone flap

Answer 2

• Any bone defect >6cm
• Any segmental mandibular defect regardless of size (except lateral segment which may be reconstructed with soft tissue only
• avascular femoral head