ABSTRACT
A free vascularized bone graft harvested from the supracondylar region of the femur
was used to treat patients with nonunion but without a massive bone defect. This graft
is vascularized by the descending genicular artery (DGA). In patients with femur nonunion,
pedicled vascularized bone grafts are usable in some cases. To confirm the applicable
range of this graft, we performed dissection of the DGAs in 16 lower limbs of eight
embalmed cadavers. A pedicled bone graft from the supracondylar region of the femur
was harvested and rotated proximally to the femur as far as possible. The distance
from the apex of the medial epicondyle to the central point of the transferred bone
(DMEB) was measured. DMEBs ranged from 13.0 to 20.0 cm (mean, 17.3). Dividing the
DMEB by femoral length we defined as the transposition ratio. Transposition ratios
ranged from 0.48 to 0.70 (mean, 0.60). These results showed we could transfer enough
graft to a distal half of the femur. This technique has a good indication for intractable
nonunion without significant bone defects of the distal half of the femur where conventional
techniques are not practical.
KEYWORDS
Vascularized bone graft - femur - nonunion - pedicle - descending genicular artery
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Atsushi YoshidaM.D.
Department of Orthopedic Surgery, Nara Medical University
840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan
Email: atsu0115@yahoo.co.jp