Rysz Maciej, Grabczan Wojciech, Mazurek Maciej Jan, Krajewski Romuald, Grzelecki Dariusz, Ciszek Bogdan
Warsaw, Poland.
From the Head and Neck Cancer Department, Memorial Cancer Center Institute of Oncology; and the Department of Descriptive and Clinical Anatomy, Warsaw Medical University.
Plast Reconstr Surg. 2017 Apr;139(4):992-997. doi: 10.1097/PRS.0000000000003155.
A small size and difficulties with shaping a medial femoral condyle corticocancellous bone flap are factors limiting its use. The goal of this study was to evaluate range of vascular supply to a medial femoral condyle corticocancellous bone flap to determine whether harvesting of larger flaps and performing a flap osteotomy would compromise the vasculature of a flap's bone.
Twenty-four limbs were dissected and medial femoral condyle corticocancellous bone flaps were harvested with skin paddles. Thirteen of 24 flaps had subperiosteal osteotomies simulating shaping a bone for reconstruction. A pedicle artery was perfused with red latex. Medial femoral condyle corticocancellous bone flap vascularization was evaluated by cutting the bone into 1-cm blocks and assessing the number of Haversian canals filled with red latex.
Length of harvested flaps was 7 to 13 cm, thickness was 0.5 to 3 cm, and width was 1 to 3 cm. Pedicle length was between 3.5 and 9 cm (mean ± SD, 6.6 ± 1.6 cm). Red latex filled bone vessels at a distance of 6 to 11.5 cm from the distal end of a flap (8.2 ± 1.4 cm). Skin paddles were filled with latex in all cases.
A medial femoral condyle corticocancellous bone flap had sufficient blood supply, allowing for harvesting flaps up to 11 cm long, and subperiosteal osteotomy did not compromise the vasculature of the flap's bone.
股骨内侧髁皮质松质骨瓣体积小以及塑形困难是限制其应用的因素。本研究的目的是评估股骨内侧髁皮质松质骨瓣的血管供应范围，以确定切取更大的骨瓣及进行骨瓣截骨术是否会损害骨瓣的血管系统。
解剖24条肢体，切取带皮瓣的股骨内侧髁皮质松质骨瓣。24个骨瓣中有13个进行了骨膜下截骨，模拟为重建而塑形骨。用红色乳胶灌注蒂动脉。通过将骨切成1厘米的骨块并评估充满红色乳胶的哈弗斯管数量来评估股骨内侧髁皮质松质骨瓣的血管化情况。
切取的骨瓣长度为7至13厘米，厚度为0.5至3厘米，宽度为1至3厘米。蒂长度在3.5至9厘米之间（均值±标准差，6.6±1.6厘米）。红色乳胶在距骨瓣远端6至11.5厘米处（8.2±1.4厘米）充盈骨血管。所有病例中皮瓣均充满乳胶。
股骨内侧髁皮质松质骨瓣有足够的血液供应，允许切取长达11厘米的骨瓣，且骨膜下截骨不会损害骨瓣的血管系统。
