Vascularized Bone Graft from the Supracondylar Region of the Femur for the Hindfoot and Ankle

Abstract

　In this report, the results of applications of thin corticoperiosteal grafts harvested from the supracondylar region of the femur for post-traumatic non-union or avascular necrosis of the tarsal bone are presented. Post-traumatic morphological changes of the tarsal bone due to non-union and/or avascular necrosis are difficult therapeutic challenges. After the development of osteoarthrosis and advancement of destruction of the anatomical alignment of the foot, arthrodesis is indicated. To prevent this, it is necessary to achieve bone union and revascularization of necrotic bone. Vascularized bone grafts can preserve the talus when secondary osteoarthrosis has not developed. Therefore, free vascularized thin corticoperiosteal grafts were used to treat patients with non-union of navicular fractures and post-traumatic avascular necrosis of the talus in whom conventional treatment failed. As this graft consists of periosteum with a thin layer of outer cortical bone, it is elastic and readily conforms to the recipient bed configuration. Uneventful bony union was achieved in all patients.