Our new free vascularized periosteal graft with thin cortical bone is introduced in this paper. It is harvested from the medial condyle and supracondyle of the femur including the thin cortical bone leaving the cambium layer of the periosteum intact, and the vascular pedicle consists of the descending genicular artery and veins.
Four cases of pseudarthrosis with small bone defects in the upper limb were treated with this procedure. They were all those where several conventional bone grafts had failed. But, except for one very recent case, bone union was achieved within 2.5 months postoperatively. And complications have not been seen at all. In addition, our procedure is very easy to perform.
In conclusion, our vascularized periosteal graft with thin cortical bone is thought to be a more reliable method to achieve early bone union even for a difficult pseudarthrosis with a poor vascularized or infectious recipient bed.
