2012 Volume 25 Issue 1 Pages 43-47
Free vascularized osteoperiosteal bone graft harvested from the medial femoral condyle is an effective tool to treat nonunion or necrosis of bone. It can be taken as a thin pliable osteoperiosteal bone or a small corticocancellous strut bone. The former is suitable for being wrapped around the site of nonunion of long bones and the latter can be packed into a small bone defect created after curettage of necrotic bone. We treated seven cases with bone nonunion (ulna, clavicle, scaphoid, talus and intercarpal space after the four corner fusion: each one, radius: 2) and three cases with osteonecrosis (capitulum of the humerus: 1 and talus: 2) using this graft. In all cases, the descending genicular arteries were present. Bone union was achieved in all cases except the patient with nonunion of the ulna. In the patient with systemic lupus erythematosus demonstrating the talus necrosis, the talus was collapsed within two years after surgery although the transplanted bone was confirmed to survive by MRI examination. Numbness appeared in the area innervated by the saphenous nerve of the donor legs in six patients including five patients from whom monitoring skin flaps had been simultaneously harvested.
