title: Free vascularized medial femoral condyle corticocancellous flap for treatment of challenging upper extremity nonunions.
abstract: BACKGROUND
  Nonunions in the upper extremity are challenging for the reconstructive surgeon. The evolution of microsurgical techniques has allowed for the reliable use of free vascularized bone flaps.
  
  
  METHODS
  In a retrospective study, patients with challenging upper limb nonunions who underwent free vascularized corticocancellous flaps from the medial femoral condyle (MFC) were included. Patient demographics, surgical technique, and outcomes were evaluated.
  
  
  RESULTS
  Fifteen patients with nonunions of the upper extremity underwent free MFC corticocancellous flap reconstruction. The length of preoperative bone defects ranged from 0.8 to 3 cm, and the mean number of procedure prior to free MFC reconstruction was 1.5. Thirteen patients healed completely in an average of 15 weeks (range, 8-22 weeks). Two patients were lost to follow-up. Only one patient required additional surgery. Functional outcome measures such as Mayo, Disability of Arm, Shoulder, and Hand, and Constant-Murley scores all demonstrated improvement.
  
  
  CONCLUSIONS
  The free vascularized MFC corticocancellous flap can be successfully used for challenging upper extremity nonunions and small bone defects.
authors.affiliation: Department of Hand Surgery and Microsurgery, Affiliated Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan City, Hu Bei Province, People's Republic of China.
authors.forename: Wu
authors.initials: W
authors.lastname: Fei
authors.affiliation: Department of Hand Surgery and Microsurgery, Affiliated Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan City, Hu Bei Province, People's Republic of China.
authors.forename: Xing
authors.initials: X
authors.lastname: Danmou
authors.affiliation: Department of Hand Surgery and Microsurgery, Affiliated Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan City, Hu Bei Province, People's Republic of China.
authors.forename: Ren
authors.initials: R
authors.lastname: Dong
authors.affiliation: Department of Hand Surgery and Microsurgery, Affiliated Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan City, Hu Bei Province, People's Republic of China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wei
authors.affiliation: Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Eberlin
authors.affiliation: Department of Hand Surgery and Microsurgery, Affiliated Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan City, Hu Bei Province, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Yan
authors.affiliation: Department of Hand Surgery and Microsurgery, Affiliated Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan City, Hu Bei Province, People's Republic of China.
authors.forename: Kan
authors.initials: K
authors.lastname: Wusheng
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D050278:Finger Phalanges / Q000293:injuries; D005599:Fractures, Ununited / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000293:injuries; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*; D034941:Upper Extremity / Q000293:injuries*; D055815:Young Adult