ABSTRACT
The periosteum of the medial femoral condyle and supracondylar region is supplied
by branches of the descending genicular artery and can be harvested as a corticoperiosteal
free flap with or without cancellous bone. This flap offers an alternative to other
types of vascularized bone grafts providing a thin and pliable sheet of osteogenic
tissue that can be transferred to sites of problematic fracture nonunions. The highly
osteogenic nature of the periosteum combined with its excellent vascularity after
microvascular or pedicled transfer achieves a high success rate in treating difficult
nonunions where conventional bone grafts have either failed or are not suitable. Donor-site
morbidity is minimal. This article provides an overview of the anatomic basis, indications,
and operative technique for the use of this flap.
KEYWORDS
Vascularized periosteal graft - medial femoral condyle - nonunion - free flap
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Steven L MoranM.D.
Associate Professor in Plastic Surgery and Orthopedics, Mayo Clinic
200 First Street SW, Rochester, MN 55905
