Medial Femoral Condyle Flap with Dr. Jason Ko

Flap Cast

  • Listen on Apple Podcasts
  • Listen on Google Podcasts

Anatomy Overview:

  • Increasingly popular flap for small to medium sized bony defects with indications for vascularized bone
  • Used predominantly for bony reconstruction of the hand and wrist but has been described for a variety of unique bony defects of the upper and lower extremities.
  • Reliable flap, consistent arterial anatomy and pedicle size, minimal donor site morbidity
  • Arterial Supply:
    • Most common – Descending Genicular Artery
      • Originates from the SFA, runs just deep or lateral to the adductor magnus tendon
      • Has three terminal branches – Articular branch (periosteum and cartilage), muscular branch (vastus medialis) and saphenous branch (overlying skin/subcutaneous tissue)
    • Alternatively – Superomedial Genicular Artery
      • In some cases, may be the dominant pedicle to the MFC flap
      • Originates from popliteal artery, crosses deep to the adductor magnus tendon to anastomose with the articular branches of the DGA
  • Venous Drainage is typically from the paired VCs that run with EITHER the DGA or SGA

Topics Covered:

  • General thoughts on the MFC flap, is it a flap you commonly use? What do you use it for in your practice?
  • What do you think are some of the advantages vs. other vascularized bone flaps (fibula, iliac crest)
    • Advantages vs. NONvascularized bone grafts vs. pedicled bone grafts
  • How do you like to do your markings? Skin paddle vs. without.
  • Dissection:
    • Initial incision and dissection landmarks
    • Pedicle identification
    • Osteotomies
    • If you need to base your flap off of the SGA at what point do you make this decision and how does your approach change?
  • How large of a bone flap/skin paddle can you take?
  • Inset (if using for scaphoid):
    • How do you fixate your flap – K wire, screw, etc?
  • Medial Trochlear Flap
    • Advantages vs. disadvantages?
  • Flap monitoring?
    • Do you monitor your MFCs?
  • Donor Site Morbidity:
    • Any issues with ambulation, knee instability, etc?

Get Notified

Subscribe to our newsletter to receive the latest updates about our hosts and podcast.