Four Cases of Severe Trauma to the Hand and Forearm Treated with Free Medial Femoral Condyle Flap Using the Cutaneous and Osteoarticular Branch of the Descending Genicular Artery

Abstract

　We treated four cases of severe hand and forearm trauma using a free medial femoral condyle flap, utilizing the cutaneous and osteoarticular branches of the descending genicular artery. Two cases were open hand fractures with infected pseudarthrosis or soft tissue and bone defects, and two cases were open forearm fractures with soft tissue and bone defects. Two patients were treated with osteocutaneous flaps, and two patients with osteoadipofascial flaps. The bone defects ranged in size from 2×0.5 cm to 3×2 cm, and the dimensions of the elevated skin valves varied from 2×1 cm to 9×6 cm. In all cases, bone union was achieved within 6 months postoperatively. However, one case exhibited necrosis of the peripheral margins of the cutaneous flap extending 2 cm wide. No complications were observed in the other cases.　
　The medial femoral condylar flap, utilizing the cutaneous and osteoarticular branch of the descending genicular artery, was beneficial in managing bone and soft tissue defects of the hand and forearm, primarily due to its ease of elevation.