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CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 082-095
DOI: 10.1055/s-0042-1758639
Hand/Peripheral Nerve
Review Article

Vascularized Bone Graft Reconstruction for Upper Extremity Defects: A Review

Ava G. Chappell 
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Matthew D. Ramsey 
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Parinaz J. Dabestani 
2   Division of Plastic and Reconstructive Surgery, Department of Surgery, Loyola University Medical Center, Maywood, Illinois
,
Jason H. Ko 
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations Funding None.
› Further Information
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Abstract

Upper extremity reconstruction may pose clinical challenges for surgeons due to the often-critical, complex functional demands of the damaged and/or missing structures. The advent of vascularized bone grafts (VBGs) has aided in reconstruction of upper extremity (UE) defects due to their superior regenerative properties compared with nonvascularized bone grafts, ability to reconstruct large bony defects, and multiple donor site options. VBGs may be pedicled or free transfers and have the potential for composite tissue transfers when bone and soft tissue are needed. This article provides a comprehensive up-to-date review of VBGs, the commonly reported donor sites, and their indications for the treatment of specific UE defects.

Keywords

vascularized bone graft - upper extremity - composite tissue transfer - microsurgery - reconstructive surgery - surgical flaps - pedicled bone graft - free bone graft

Authors' Contributions

J.H.K., A.G.C., M.D.R, and P.J.D. contributed to conceptualization, writing-review & editing: all authors. A.G.C., M.D.R., and P.J.D. wrote original draft. J.H.K supervised the study. All authors A.G.C., M.D.R., P.J.D., J.H.K. contributed to the creation of the manuscript and meet the criteria for authorship.


Patient Consent

Written consents for clinical photographs were obtained from patients.




Publication History

Received: 19 September 2021

Accepted: 04 August 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Huntington TW. VI. case of bone transference: use of a segment of fibula to supply a defect in the tibia. Ann Surg 1905; 41 (02) 249-251
    PubMedGoogle Scholar
  • 2 Taylor GI, Miller GD, Ham FJ. The free vascularized bone graft. A clinical extension of microvascular techniques. Plast Reconstr Surg 1975; 55 (05) 533-544
    CrossrefPubMedGoogle Scholar
  • 3 Repo JP, Sommarhem A, Roine RP, Sintonen H, Halonen T, Tukiainen E. Free vascularized fibular graft is reliable in upper extremity long-bone reconstruction with good long-term outcomes. J Reconstr Microsurg 2016; 32 (07) 513-519
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Barrera-Ochoa SS, Soldado F, Rodriguez-Baeza A. et al. Vascularized humeral periosteal flap to treat lateral humeral condyle nonunion: an anatomical study and report of two successfully-treated pediatric cases. Microsurgery 2019; 39 (02) 156-159
    CrossrefPubMedGoogle Scholar
  • 5 Hilven PH, Bayliss L, Cosker T. et al. The vascularised fibular graft for limb salvage after bone tumour surgery: a multicentre study. Bone Joint J 2015; 97-B (06) 853-861
    CrossrefPubMedGoogle Scholar
  • 6 Inoue K, Suenaga N, Oizumi N, Tanaka Y, Minami A. A vascularized scapular graft for juvenile osteonecrosis of the humeral head. J Shoulder Elbow Surg 2012; 21 (04) e9-e13
    CrossrefPubMedGoogle Scholar
  • 7 Fillingham Y, Jacobs J. Bone grafts and their substitutes. Bone Joint J 2016; 98-B (1, Suppl A): 6-9
    CrossrefPubMedGoogle Scholar
  • 8 Karalashvili L, Kakabadze A, Uhryn M, Vyshnevska H, Ediberidze K, Kakabadze Z. Bone grafts for reconstruction of bone defects. (Review) Georgian Med News 2018; ••• (282) 44-49
    Google Scholar
  • 9 Martin WB, Sicard R, Namin SM, Ganey T. Methods of cryoprotectant preservation: allogeneic cellular bone grafts and potential effects. BioMed Res Int 2019; 2019: 5025398
    CrossrefPubMedGoogle Scholar
  • 10 Roberts TT, Rosenbaum AJ. Bone grafts, bone substitutes and orthobiologics: the bridge between basic science and clinical advancements in fracture healing. Organogenesis 2012; 8 (04) 114-124
    CrossrefPubMedGoogle Scholar
  • 11 Azi ML, Aprato A, Santi I, Kfuri Jr M, Masse A, Joeris A. Autologous bone graft in the treatment of post-traumatic bone defects: a systematic review and meta-analysis. BMC Musculoskelet Disord 2016; 17 (01) 465
    CrossrefPubMedGoogle Scholar
  • 12 Myeroff C, Archdeacon M. Autogenous bone graft: donor sites and techniques. J Bone Joint Surg Am 2011; 93 (23) 2227-2236
    CrossrefPubMedGoogle Scholar
  • 13 Ashman O, Phillips AM. Treatment of non-unions with bone defects: which option and why?. Injury 2013; 44 (Suppl. 01) S43-S45
    CrossrefPubMedGoogle Scholar
  • 14 Klifto CS, Gandi SD, Sapienza A. Bone graft options in upper-extremity surgery. J Hand Surg Am 2018; 43 (08) 755-761.e2
    CrossrefPubMedGoogle Scholar
  • 15 Allsopp BJ, Hunter-Smith DJ, Rozen WM. Vascularized versus nonvascularized bone grafts: what is the evidence?. Clin Orthop Relat Res 2016; 474 (05) 1319-1327
    CrossrefPubMedGoogle Scholar
  • 16 Hovius SER, de Jong T. Bone grafts for scaphoid nonunion: an overview. Hand Surg 2015; 20 (02) 222-227
    CrossrefPubMedGoogle Scholar
  • 17 Merrell GA, Wolfe SW, Slade III JF. Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am 2002; 27 (04) 685-691
    CrossrefPubMedGoogle Scholar
  • 18 Munk B, Larsen CF. Bone grafting the scaphoid nonunion: a systematic review of 147 publications including 5,246 cases of scaphoid nonunion. Acta Orthop Scand 2004; 75 (05) 618-629
    CrossrefPubMedGoogle Scholar
  • 19 Scholz AO, Gehrmann S, Glombitza M. et al. Reconstruction of septic diaphyseal bone defects with the induced membrane technique. Injury 2015; 46 (Suppl. 04) S121-S124
    CrossrefPubMedGoogle Scholar
  • 20 Masquelet AC, Fitoussi F, Begue T, Muller GP. [Reconstruction of the long bones by the induced membrane and spongy autograft]. Ann Chir Plast Esthet 2000; 45 (03) 346-353
    PubMedGoogle Scholar
  • 21 Karger C, Kishi T, Schneider L, Fitoussi F, Masquelet A-C. French Society of Orthopaedic Surgery and Traumatology (SoFCOT). Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res 2012; 98 (01) 97-102
    CrossrefPubMedGoogle Scholar
  • 22 Pelissier P, Bollecker V, Martin D, Baudet J. [Foot reconstruction with the “bi-Masquelet” procedure]. Ann Chir Plast Esthet 2002; 47 (04) 304-307
    PubMedGoogle Scholar
  • 23 Petrella G, Tosi D, Pantaleoni F, Adani R. Vascularized bone grafts for post-traumatic defects in the upper extremity. Arch Plast Surg 2021; 48 (01) 84-90
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Malizos KN, Zalavras CG, Soucacos PN, Beris AE, Urbaniak JR. Free vascularized fibular grafts for reconstruction of skeletal defects. J Am Acad Orthop Surg 2004; 12 (05) 360-369
    CrossrefPubMedGoogle Scholar
  • 25 Houdek MT, Wagner ER, Wyles CC, Nanos III GP, Moran SL. New options for vascularized bone reconstruction in the upper extremity. Semin Plast Surg 2015; 29 (01) 20-29
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Karaismailoglu B, Fatih Guven M, Erenler M, Botanlioglu H. The use of pedicled vascularized bone grafts in the treatment of scaphoid nonunion: clinical results, graft options and indications. EFORT Open Rev 2020; 5 (01) 1-8
    CrossrefPubMedGoogle Scholar
  • 27 Zaidemberg C, Siebert JW, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg Am 1991; 16 (03) 474-478
    CrossrefPubMedGoogle Scholar
  • 28 Alluri RK, Yin C, Iorio ML, Leland H, Mack WJ, Patel K. A critical appraisal of vascularized bone grafting for scaphoid nonunion. J Wrist Surg 2017; 6 (03) 251-257
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicled bone grafts. J Hand Surg Am 1995; 20 (06) 902-914
    CrossrefPubMedGoogle Scholar
  • 30 Waitayawinyu T, Robertson C, Chin SH, Schlenker JD, Pettrone S, Trumble TE. The detailed anatomy of the 1,2 intercompartmental supraretinacular artery for vascularized bone grafting of scaphoid nonunions. J Hand Surg Am 2008; 33 (02) 168-174
    CrossrefPubMedGoogle Scholar
  • 31 Chang MA, Bishop AT, Moran SL, Shin AY. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg Am 2006; 31 (03) 387-396
    CrossrefPubMedGoogle Scholar
  • 32 Steinmann SP, Bishop AT, Berger RA. Use of the 1,2 intercompartmental supraretinacular artery as a vascularized pedicle bone graft for difficult scaphoid nonunion. J Hand Surg Am 2002; 27 (03) 391-401
    CrossrefPubMedGoogle Scholar
  • 33 Waitayawinyu T, McCallister WV, Katolik LI, Schlenker JD, Trumble TE. Outcome after vascularized bone grafting of scaphoid nonunions with avascular necrosis. J Hand Surg Am 2009; 34 (03) 387-394
    CrossrefPubMedGoogle Scholar
  • 34 Kawamura K, Chung KC. Treatment of scaphoid fractures and nonunions. J Hand Surg Am 2008; 33 (06) 988-997
    CrossrefPubMedGoogle Scholar
  • 35 Straw RG, Davis TRC, Dias JJ. Scaphoid nonunion: treatment with a pedicled vascularized bone graft based on the 1,2 intercompartmental supraretinacular branch of the radial artery. J Hand Surg [Br] 2002; 27 (05) 413
    CrossrefPubMedGoogle Scholar
  • 36 Boyer MI, von Schroeder HP, Axelrod TS. Scaphoid nonunion with avascular necrosis of the proximal pole. Treatment with a vascularized bone graft from the dorsum of the distal radius. J Hand Surg [Br] 1998; 23 (05) 686-690
    CrossrefPubMedGoogle Scholar
  • 37 Woon Tan JS, Tu YK. 2,3 intercompartmental supraretinacular artery pedicled vascularized bone graft for scaphoid nonunions. Tech Hand Up Extrem Surg 2013; 17 (02) 62-67
    CrossrefPubMedGoogle Scholar
  • 38 Moran SL, Cooney WP, Berger RA, Bishop AT, Shin AY. The use of the 4 + 5 extensor compartmental vascularized bone graft for the treatment of Kienböck's disease. J Hand Surg Am 2005; 30 (01) 50-58
    CrossrefPubMedGoogle Scholar
  • 39 Ye X, Feng J-T, Yin H-W, Qiu Y-Q, Shen Y-D, Xu W-D. Use of 4+5 extensor compartmental vascularized bone graft and K-wire fixation for treating stage II-IIIA Kienböck's disease. Hand Surg Rehabil 2020; 39 (03) 207-213
    CrossrefPubMedGoogle Scholar
  • 40 Özalp T, Öz Ç, Kale G, Erkan S. Scaphoid nonunion treated with vascularised bone graft from dorsal radius. Injury 2015; 46 (Suppl. 02) S47-S52
    CrossrefPubMedGoogle Scholar
  • 41 Sotereanos DG, Darlis NA, Dailiana ZH, Sarris IK, Malizos KN. A capsular-based vascularized distal radius graft for proximal pole scaphoid pseudarthrosis. J Hand Surg Am 2006; 31 (04) 580-587
    CrossrefPubMedGoogle Scholar
  • 42 Kuhlmann JN, Mimoun M, Boabighi A, Baux S. Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid. J Hand Surg [Br] 1987; 12 (02) 203-210
    Google Scholar
  • 43 Mathoulin C, Haerle M. Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion. J Hand Surg [Br] 1998; 23 (03) 318-323
    CrossrefPubMedGoogle Scholar
  • 44 Dailiana ZH, Malizos KN, Zachos V, Varitimidis SE, Hantes M, Karantanas A. Vascularized bone grafts from the palmar radius for the treatment of waist nonunions of the scaphoid. J Hand Surg Am 2006; 31 (03) 397-404
    CrossrefPubMedGoogle Scholar
  • 45 Malizos KN, Zachos V, Dailiana ZH. et al. Scaphoid nonunions: management with vascularized bone grafts from the distal radius: a clinical and functional outcome study. Plast Reconstr Surg 2007; 119 (05) 1513-1525
    CrossrefPubMedGoogle Scholar
  • 46 Mathoulin C, Sallen V, Haerle M. Revascularisation of the lunate in Kienbock's disease by a vascularized bone graft harvested from the volar aspect of the radius: results after a minimum of five years follow-up. Rev Chir Orthop Repar Appar 2007; 93: 141
    Google Scholar
  • 47 Kawai H, Yamamoto K. Pronator quadratus pedicled bone graft for old scaphoid fractures. J Bone Joint Surg Br 1988; 70 (05) 829-831
    CrossrefPubMedGoogle Scholar
  • 48 Noaman HH, Shiha AE, Ibrahim AKH. Functional outcomes of nonunion scaphoid fracture treated by pronator quadratus pedicled bone graft. Ann Plast Surg 2011; 66 (01) 47-52
    CrossrefPubMedGoogle Scholar
  • 49 Lee SK, Park JS, Choy WS. Scaphoid fracture nonunion treated with pronator quadratus pedicled vascularized bone graft and headless compression screw. Ann Plast Surg 2015; 74 (06) 665-671
    CrossrefPubMedGoogle Scholar
  • 50 Malizos KN, Dailiana ZH, Innocenti M, Mathoulin CL, Mattar Jr R, Sauerbier M. Vascularized bone grafts for upper limb reconstruction: defects at the distal radius, wrist, and hand. J Hand Surg Am 2010; 35 (10) 1710-1718
    CrossrefPubMedGoogle Scholar
  • 51 Saffar P. [Replacement of the semilunar bone by the pisiform. Description of a new technique for the treatment of Kienboeck's disease]. Ann Chir Main 1982; 1 (03) 276-279
    PubMedGoogle Scholar
  • 52 Tan Z, Xiang Z, Huang F, Yang Z, Xiao C, Duan X. Long-term results of vascularized os pisiform transfer for advanced Kienböck disease after follow-up for at least 15 years: a case series. Medicine (Baltimore) 2018; 97 (48) e13229
    CrossrefPubMedGoogle Scholar
  • 53 Pierer G, Steffen J, Hoflehner H. The vascular blood supply of the second metacarpal bone: anatomic basis for a new vascularized bone graft in hand surgery. An anatomical study in cadavers. Surg Radiol Anat 1992; 14 (02) 103-112
    CrossrefPubMedGoogle Scholar
  • 54 Brunelli F, Mathoulin C, Saffar P. [Description of a vascularized bone graft taken from the head of the 2nd metacarpal bone]. Ann Chir Main Memb Super 1992; 11 (01) 40-45
    PubMedGoogle Scholar
  • 55 Khan K, Riaz M, Small JO. The use of the second dorsal metacarpal artery for vascularized bone graft. An anatomical study. J Hand Surg [Br] 1998; 23 (03) 308-310
    CrossrefPubMedGoogle Scholar
  • 56 Pistré V, Réau AF, Pélissier P, Martin D, Baudet J. [Vascularized bone pedicle grafts of the hand and wrist: literature review and new donor sites]. Chir Main 2001; 20 (04) 263-271
    PubMedGoogle Scholar
  • 57 Santa-Comba A, Amarante J, Silva A, Rodrigues J. Reverse dorsal metacarpal osteocutaneous flap. Br J Plast Surg 1997; 50 (07) 555-558
    CrossrefPubMedGoogle Scholar
  • 58 Bengoechea-Beeby MP, Cepeda-Uña J, Abascal-Zuloaga A. Vascularized bone graft from the index metacarpal for Kienböck's disease: a case report. J Hand Surg Am 2001; 26 (03) 437-443
    CrossrefPubMedGoogle Scholar
  • 59 Innocenti M, Delcroix L, Romano GF. Epiphyseal transplant: harvesting technique of the proximal fibula based on the anterior tibial artery. Microsurgery 2005; 25 (04) 284-292
    CrossrefPubMedGoogle Scholar
  • 60 Innocenti M, Mori F, Raffaini M, Lucattelli E, Innocenti A. Mandibular ramus and condyle reconstruction with vascularized proximal fibular epiphyseal transfer in the pediatric patient: a case report. Microsurgery 2020; 40 (07) 818-822
    CrossrefPubMedGoogle Scholar
  • 61 Bumbasirevic M, Stevanovic M, Bumbasirevic V, Lesic A, Atkinson HDE. Free vascularised fibular grafts in orthopaedics. Int Orthop 2014; 38 (06) 1277-1282
    CrossrefPubMedGoogle Scholar
  • 62 Abou-Foul AK, Borumandi F. Anatomical variants of lower limb vasculature and implications for free fibula flap: systematic review and critical analysis. Microsurgery 2016; 36 (02) 165-172
    CrossrefPubMedGoogle Scholar
  • 63 Korompilias AV, Paschos NK, Lykissas MG, Kostas-Agnantis I, Vekris MD, Beris AE. Recent updates of surgical techniques and applications of free vascularized fibular graft in extremity and trunk reconstruction. Microsurgery 2011; 31 (03) 171-175
    CrossrefPubMedGoogle Scholar
  • 64 Liu S, Tao S, Tan J, Hu X, Liu H, Li Z. Long-term follow-up of fibular graft for the reconstruction of bone defects. Medicine (Baltimore) 2018; 97 (40) e12605
    CrossrefPubMedGoogle Scholar
  • 65 Capanna R, Bufalini C, Campanacci M. A new technique for reconstructions of large metadiaphyseal bone defects. Orthop Traumatol 1993; 2: 159-177
    CrossrefGoogle Scholar
  • 66 Jones Jr DB, Bürger H, Bishop AT, Shin AY. Treatment of scaphoid waist nonunions with an avascular proximal pole and carpal collapse. Surgical technique. J Bone Joint Surg Am 2009; 91 (Suppl. 02) 169-183
    CrossrefPubMedGoogle Scholar
  • 67 Tonoli C, Bechara AHS, Rossanez R, Belangero WD, Livani B. Use of the vascularized iliac-crest flap in musculoskeletal lesions. BioMed Res Int 2013; 2013: 237146
    CrossrefPubMedGoogle Scholar
  • 68 Harpf C, Gabl M, Reinhart C. et al. Small free vascularized iliac crest bone grafts in reconstruction of the scaphoid bone: a retrospective study in 60 cases. Plast Reconstr Surg 2001; 108 (03) 664-674
    CrossrefPubMedGoogle Scholar
  • 69 Sakai K, Doi K, Kawai S. Free vascularized thin corticoperiosteal graft. Plast Reconstr Surg 1991; 87 (02) 290-298
    CrossrefPubMedGoogle Scholar
  • 70 Oh C, Pulos N, Bishop AT, Shin AY. Intraoperative anatomy of the vascular supply to the medial femoral condyle. J Plast Reconstr Aesthet Surg 2019; 72 (09) 1503-1508
    CrossrefPubMedGoogle Scholar
  • 71 Yamamoto H, Jones Jr DB, Moran SL, Bishop AT, Shin AY. The arterial anatomy of the medial femoral condyle and its clinical implications. J Hand Surg Eur Vol 2010; 35 (07) 569-574
    CrossrefPubMedGoogle Scholar
  • 72 Ziegler T, Kamolz L-P, Vasilyeva A, Schintler M, Neuwirth M, Parvizi D. Descending genicular artery. Branching patterns and measuring parameters: a systematic review and meta-analysis of several anatomical studies. J Plast Reconstr Aesthet Surg 2018; 71 (07) 967-975
    CrossrefPubMedGoogle Scholar
  • 73 Iorio ML, Masden DL, Higgins JP. Cutaneous angiosome territory of the medial femoral condyle osteocutaneous flap. J Hand Surg Am 2012; 37 (05) 1033-1041
    CrossrefPubMedGoogle Scholar
  • 74 Hsu C-C, Tseng J, Lin Y-T. Chimeric medial femoral condyle osteocutaneous flap for reconstruction of multiple metacarpal defects. J Hand Surg Am 2018; 43 (08) 781.e1-781.e9
    CrossrefPubMedGoogle Scholar
  • 75 Bürger HK, Windhofer C, Gaggl AJ, Higgins JP. Vascularized medial femoral trochlea osteocartilaginous flap reconstruction of proximal pole scaphoid nonunions. J Hand Surg Am 2013; 38 (04) 690-700
    CrossrefPubMedGoogle Scholar
  • 76 Higgins JP, Bürger HK. Osteochondral flaps from the distal femur: expanding applications, harvest sites, and indications. J Reconstr Microsurg 2014; 30 (07) 483-490
    Article in Thieme ConnectPubMedGoogle Scholar
  • 77 Higgins JP, Bürger HK. Medial femoral trochlea osteochondral flap: applications for scaphoid and lunate reconstruction. Clin Plast Surg 2020; 47 (04) 491-499
    CrossrefPubMedGoogle Scholar
  • 78 Hugon S, Koninckx A, Barbier O. Vascularized osteochondral graft from the medial femoral trochlea: anatomical study and clinical perspectives. Surg Radiol Anat 2010; 32 (09) 817-825
    CrossrefPubMedGoogle Scholar
  • 79 Kälicke T, Bürger H, Müller EJ. [A new vascularized cartilague-bone-graft for scaphoid nonunion with avascular necrosis of the proximal pole. Description of a new type of surgical procedure]. Unfallchirurg 2008; 111 (03) 201-205
    PubMedGoogle Scholar
  • 80 Boghossian E, Stewart DA. The medial metaphyseal periosteal artery (MMPA): an alternate pedicle for the medial femoral trochlea flap. J Hand Surg Am 2021; 46 (11) 1032.e1-1032.e3
    CrossrefPubMedGoogle Scholar
  • 81 Hill JR, Heckmann N, McKnight B, White EA, Ghiassi A, Patel BA. Medial femoral trochlea osteochondral graft: a quantitative anatomic comparison to the proximal pole of the scaphoid. J Wrist Surg 2020; 9 (04) 283-288
    Article in Thieme ConnectPubMedGoogle Scholar
  • 82 Shin JJ, Haro M, Yanke AB. et al. Topographic analysis of the capitellum and distal femoral condyle: finding the best match for treating osteochondral defects of the humeral capitellum. Arthroscopy 2015; 31 (05) 843-849
    CrossrefPubMedGoogle Scholar
  • 83 Mehio G, Morsy M, Cayci C. et al. Donor-site morbidity and functional status following medial femoral condyle flap harvest. Plast Reconstr Surg 2018; 142 (05) 734e-741e
    CrossrefPubMedGoogle Scholar
  • 84 Rao SS, Sexton CC, Higgins JP. Medial femoral condyle flap donor-site morbidity: a radiographic assessment. Plast Reconstr Surg 2013; 131 (03) 357e-362e
    CrossrefPubMedGoogle Scholar
  • 85 Son JH, Giladi AM, Higgins JP. Iatrogenic femur fracture following medial femoral condyle flap harvest eventually requiring total knee arthroplasty in one patient. J Hand Surg Eur Vol 2019; 44 (03) 320-321
    CrossrefPubMedGoogle Scholar
  • 86 Parvizi D, Vasilyeva A, Wurzer P. et al. Anatomy of the vascularized lateral femoral condyle flap. Plast Reconstr Surg 2016; 137 (06) 1024e-1032e
    CrossrefPubMedGoogle Scholar
  • 87 Wong VW, Bürger HK, Iorio ML, Higgins JP. Lateral femoral condyle flap: an alternative source of vascularized bone from the distal femur. J Hand Surg Am 2015; 40 (10) 1972-1980
    CrossrefPubMedGoogle Scholar
  • 88 Higgins JP, Bürger HK. The use of osteochondral flaps in the treatment of carpal disorders. J Hand Surg Eur Vol 2018; 43 (01) 48-56
    CrossrefPubMedGoogle Scholar
  • 89 Windhofer CM, Anoshina M, Ivusits P, Bürger HP. The free vascularized lateral femoral trochlea osteochondral graft: a reliable alternative for Stage III Kienböck's disease. J Hand Surg Eur Vol 2021; 46 (10) 1032-1041
    CrossrefPubMedGoogle Scholar
  • 90 Kawamura K, Kawate K, Yajima H, Kobata Y, Takakura Y. Vascularized scapular grafting for treatment of osteonecrosis of the humeral head. J Reconstr Microsurg 2008; 24 (08) 559-564
    Article in Thieme ConnectPubMedGoogle Scholar
  • 91 Swartz WM, Banis JC, Newton ED, Ramasastry SS, Jones NF, Acland R. The osteocutaneous scapular flap for mandibular and maxillary reconstruction. Plast Reconstr Surg 1986; 77 (04) 530-545
    CrossrefPubMedGoogle Scholar
  • 92 Elia R, Di Taranto G, Amorosi V. et al. The versatility of the thoracodorsal artery based composite flaps with vascularized rib and a systematic review of the literature. J Surg Oncol 2019; 120 (03) 527-539
    CrossrefPubMedGoogle Scholar
  • 93 Sia WT, Xu GG, Puhaindran ME, Tan BK, Cheng MHW, Chew WYC. Reconstruction of extensive soft-tissue defects with concomitant bone defects in the lower extremity with the latissimus dorsi-serratus anterior-rib free flap. J Reconstr Microsurg 2015; 31 (06) 407-413
    Article in Thieme ConnectPubMedGoogle Scholar
  • 94 Werner CML, Favre P, van Lenthe HG, Dumont CE. Pedicled vascularized rib transfer for reconstruction of clavicle nonunions with bony defects: anatomical and biomechanical considerations. Plast Reconstr Surg 2007; 120 (01) 173-180
    CrossrefPubMedGoogle Scholar
  • 95 Guelinckx PJ, Sinsel NK. The “Eve” procedure: the transfer of vascularized seventh rib, fascia, cartilage, and serratus muscle to reconstruct difficult defects. Plast Reconstr Surg 1996; 97 (03) 527-535
    CrossrefPubMedGoogle Scholar
  • 96 Thomas WO, Harris CN, Moline S, Harper LL, Parker JA. Versatility of the microvascular serratus anterior muscle vascularized rib flap (SARIB) for multifaceted requirement reconstructions. Ann Plast Surg 1998; 40 (01) 23-27
    CrossrefPubMedGoogle Scholar
  • 97 Shiokawa I, Minabe T, Momosawa A, Mashiko T. Muscular pedicled lateral chest composite flap-a new nonmicrosurgical option for forearm salvage. Plast Reconstr Surg Glob Open 2015; 2 (12) e267
    CrossrefPubMedGoogle Scholar
  • 98 Spiker AM, Humbyrd CJ, Osgood GM, Yang SC, Deune EG. Reconstruction of ulnar defect with vascularized rib graft: a case report. Microsurgery 2017; 37 (02) 160-164
    CrossrefPubMedGoogle Scholar
  • 99 Georgescu AV, Ignatiadis I, Ileana M, Irina C, Filip A, Olariu R. Long-term results after muscle-rib flap transfer for reconstruction of composite limb defects. Microsurgery 2011; 31 (03) 218-222
    CrossrefPubMedGoogle Scholar
  • 100 Hennerbichler A, Etzer C, Gruber S, Brenner E, Papp C, Gaber O. Lateral arm flap: analysis of its anatomy and modification using a vascularized fragment of the distal humerus. Clin Anat 2003; 16 (03) 204-214
    CrossrefPubMedGoogle Scholar
  • 101 Haas F, Rappl T, Koch H, Pittler P, Scharnagl E. Free osteocutaneous lateral arm flap: anatomy and clinical applications. Microsurgery 2003; 23 (02) 87-95
    CrossrefPubMedGoogle Scholar
  • 102 Windhofer C, Michlits W, Karlbauer A, Papp C. Treatment of segmental bone and soft-tissue defects of the forearm with the free osteocutaneous lateral arm flap. J Trauma 2011; 70 (05) 1286-1290
    Google Scholar
  • 103 Okada M, Takamatsu K, Oebisu N, Nakamura H. Reversed lateral upper arm flap with a vascularised fragment of the humerus for reconstruction of ulna shaft fracture after resection of malignant tumour: a case report. J Plast Reconstr Aesthet Surg 2011; Oct; 64 (10) 1373-1376
    CrossrefPubMedGoogle Scholar
  • 104 Matev I. The osteocutaneous pedicle forearm flap. J Hand Surg [Br] 1985; 10 (02) 179-182
    CrossrefPubMedGoogle Scholar
  • 105 Biemer E, Stock W. Total thumb reconstruction: a one-stage reconstruction using an osteo-cutaneous forearm flap. Br J Plast Surg 1983; 36 (01) 52-55
    CrossrefPubMedGoogle Scholar
  • 106 Chacha B, Soin K, Tan KC. One stage reconstruction of intercalated defect of the thumb using the osteocutaneous radial forearm flap. J Hand Surg [Br] 1987; 12 (01) 86-92
    CrossrefPubMedGoogle Scholar
  • 107 Yajima H, Tamai S, Ono H, Kizaki K. Vascularized bone grafts to the upper extremities. Plast Reconstr Surg 1998; 101 (03) 727-735 , discussion 736–737
    CrossrefPubMedGoogle Scholar
  • 108 Timmons MJ, Missotten FE, Poole MD, Davies DM. Complications of radial forearm flap donor sites. Br J Plast Surg 1986; 39 (02) 176-178
    CrossrefPubMedGoogle Scholar
  • 109 Momberger NG, Smith J, Coleman DA. Vascularized fibular grafts for salvage reconstruction of clavicle nonunion. J Shoulder Elbow Surg 2000; 9 (05) 389-394
    CrossrefPubMedGoogle Scholar
  • 110 Arenas-Miquelez A, Karargyris O, Olariu R, Zumstein M. Free vascularized fibular graft for reconstruction of the lateral clavicle: a case report and review of the literature. JBJS Case Connect 2019; 9 (04) e0330
    CrossrefPubMedGoogle Scholar
  • 111 Abarca J, Valle P, Valenti P. Clavicular reconstruction with free fibula flap: a report of four cases and review of the literature. Injury 2013; 44 (03) 283-287
    CrossrefPubMedGoogle Scholar
  • 112 Taylor GI, Seneviratne S, Jones I, White D, Mah E, Shayan R. Free vascularized fibula flap reconstruction of the clavicle combined with biceps tendon repair of the conoid ligament and customized plate stabilization of the acromioclavicular joint. Plast Reconstr Surg 2009; 123 (03) 113e-115e
    CrossrefPubMedGoogle Scholar
  • 113 Lenoir H, Williams T, Kerfant N, Robert M, Le Nen D. Free vascularized fibular graft as a salvage procedure for large clavicular defect: a two cases report. Orthop Traumatol Surg Res 2013; 99 (07) 859-863
    CrossrefPubMedGoogle Scholar
  • 114 Jaloux C, Bettex Q, Levadoux M. et al. Free vascularized medial femoral condyle corticoperiosteal flap with non-vascularized iliac crest graft for the treatment of recalcitrant clavicle non-union. J Plast Reconstr Aesthet Surg 2020; 73 (07) 1232-1238
    CrossrefPubMedGoogle Scholar
  • 115 Deng AD, Innocenti M, Arora R, Gabl M, Tang JB. Vascularized small-bone transfers for fracture nonunion and bony defects. Clin Plast Surg 2020; 47 (04) 501-520
    CrossrefPubMedGoogle Scholar
  • 116 Medrykowski F, Barbary S, Gibert N, Lascombes P, Dautel G. Vascularized proximal fibular epiphyseal transfer: two cases. Orthop Traumatol Surg Res 2012; 98 (06) 728-732
    CrossrefPubMedGoogle Scholar
  • 117 Innocenti M, Delcroix L, Romano GF, Capanna R. Vascularized epiphyseal transplant. Orthop Clin North Am 2007; 38 (01) 95-101 , vii vii .
    CrossrefPubMedGoogle Scholar
  • 118 Ye L, Taylor GI. A 10-year follow-up of a free vascularized fibula flap clavicle reconstruction in an adult. Plast Reconstr Surg Glob Open 2017; 5 (04) e1317
    CrossrefPubMedGoogle Scholar
  • 119 Kazmers NH, Thibaudeau S, Gerety P, Lambi AG, Levin LS. Versatility of the medial femoral condyle flap for extremity reconstruction and identification of risk factors for nonunion, delayed time to union, and complications. Ann Plast Surg 2018; 80 (04) 364-372
    CrossrefPubMedGoogle Scholar
  • 120 Quintero JI, Childs D, Moreno R. The medial femoral condyle free flap: an excellent option for difficult cases: case series. SAGE Open Med Case Rep 2020; 8: X20933763
    Google Scholar
  • 121 Landau MJ, Badash I, Yin C, Alluri RK, Patel KM. Free vascularized fibula grafting in the operative treatment of malignant bone tumors of the upper extremity: A systematic review of outcomes and complications. J Surg Oncol 2018; 117 (07) 1432-1439
    CrossrefPubMedGoogle Scholar
  • 122 Bilgin SS. Reconstruction of proximal humeral defects with shoulder arthrodesis using free vascularized fibular graft. J Bone Joint Surg Am 2012; 94 (13) e94
    CrossrefPubMedGoogle Scholar
  • 123 Claxton MR, Shirley MB, Bakri K, Rose PS, Moran SL, Houdek MT. Utility of the free vascularized fibula flap to reconstruct oncologic defects in the upper extremity. Anticancer Res 2020; 40 (05) 2751-2755
    CrossrefPubMedGoogle Scholar
  • 124 Stevenson JD, Doxey R, Abudu A. et al. Vascularized fibular epiphyseal transfer for proximal humeral reconstruction in children with a primary sarcoma of bone. Bone Joint J 2018; 100-B (04) 535-541
    CrossrefPubMedGoogle Scholar
  • 125 Kurlander DE, Shue S, Schwarz GS, Ghaznavi AM. Vascularized fibula epiphysis transfer for pediatric extremity reconstruction: a systematic review and meta-analysis. Ann Plast Surg 2019; 82 (03) 344-351
    CrossrefPubMedGoogle Scholar
  • 126 Gan AWT, Puhaindran ME, Pho RWH. The reconstruction of large bone defects in the upper limb. Injury 2013; 44 (03) 313-317
    CrossrefPubMedGoogle Scholar
  • 127 Ciclamini D, Tos P, Guzzini M, Soldati A, Crosio A, Battiston B. The medial femoral condyle free corticoperiosteal flap versus traditional bone graft for treatment of nonunions of long bones: a retrospective comparative cohort study. Injury 2019; 50 (Suppl. 05) S54-S58
    CrossrefPubMedGoogle Scholar
  • 128 Henry M. Vascularized medial femoral condyle bone graft for resistant nonunion of the distal radius. J Hand Surg Asian Pac Vol 2017; 22 (01) 23-28
    CrossrefPubMedGoogle Scholar
  • 129 Amadio PC, Moran SL. Fractures of the carpal bone. In: Green DP. editor. Operative hand surgery. 5th ed. Philadelphia: Churchill Livingstone; 2005: 711-779
    Google Scholar
  • 130 Pao VS, Chang J. Scaphoid nonunion: diagnosis and treatment. Plast Reconstr Surg 2003; 112 (06) 1666-1676 , quiz 1677, discussion 1678–1679
    CrossrefPubMedGoogle Scholar
  • 131 Mattos D, Ko JH, Iorio ML. Wrist arthrodesis with the medial femoral condyle flap: Outcomes of vascularized bone grafting for osteomyelitis. Microsurgery 2019; 39 (01) 32-38
    CrossrefPubMedGoogle Scholar
  • 132 Yajima H, Tamai S, Yamauchi T, Mizumoto S. Osteocutaneous radial forearm flap for hand reconstruction. J Hand Surg Am 1999; 24 (03) 594-603
    CrossrefPubMedGoogle Scholar
  • 133 Dailiana ZH, Malizos KN, Urbaniak JR. Vascularized periosteal flaps of distal forearm and hand. J Trauma 2005; 58 (01) 76-82
    CrossrefPubMedGoogle Scholar
  • 134 Del Piñal F, García-Bernal FJ, Delgado J, Sanmartín M, Regalado J. Reconstruction of the distal radius facet by a free vascularized osteochondral autograft: anatomic study and report of a patient. J Hand Surg Am 2005; 30 (06) 1200-1210
    CrossrefPubMedGoogle Scholar
  • 135 Smith PJ, Goodacre TE. Free vascularised toe joint transfer for reconstruction of the metacarpo-phalangeal joint. J Hand Surg [Br] 1990; 15 (02) 262-267
    CrossrefPubMedGoogle Scholar
  • 136 Foucher G, Lenoble E, Smith D. Free and island vascularized joint transfer for proximal interphalangeal reconstruction: a series of 27 cases. J Hand Surg Am 1994; 19 (01) 8-16
    CrossrefPubMedGoogle Scholar
  • 137 Tsai TM, Lim BH. Free vascularized transfer of the metatarsophalangeal and proximal interphalangeal joints of the second toe for reconstruction of the metacarpophalangeal joints of the thumb and index finger using a single vascular pedicle. Plast Reconstr Surg 1996; 98 (06) 1080-1086
    CrossrefPubMedGoogle Scholar