title: Combination of microvascular medial femoral condyle and iliac crest flap for hemi-midface reconstruction.
abstract: In midface defects including the orbit (Brown class III and IV), no single flap can provide adequate reconstruction. In this technical note, the combination of vascularized iliac crest flap and vascularized medial femoral condyle flap (MFC) is described. The vascularized iliac crest flap is reported to be the gold standard for maxilla reconstruction. There is, however, no consensus on the best method for orbital and nasal wall reconstruction. The MFC flap can be harvested as a thin corticoperiosteal flap or as an osteomyocutaneous flap. Due to the periosteal blood supply, this flap can be customized for an individual defect of the upper hemi-midface. It is therefore of great benefit in orbital and nasal wall reconstruction. By combining the deep circumflex iliac artery (DCIA) bone flap and the MFC flap, the best standard reconstruction technique of the hemi-maxilla can be combined with a new anatomical precise microvascular reconstruction technique of the orbit. A nearly symmetric midface appearance can be achieved.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria. Electronic address: c.brandtner@salk.at.
authors.forename: C
authors.initials: C
authors.lastname: Brandtner
authors.affiliation: Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Hachleitner
authors.affiliation: Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Buerger
authors.affiliation: Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Gaggl
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D064595:Composite Tissue Allografts / Q000098:blood supply*; D005269:Femur / Q000637:transplantation*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008437:Maxilla / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*
keywords: DCIA flap; MFC flap; combination of microvascular flaps; reconstruction of midface defects; vascularized iliac crest flap; vascularized medial femoral condyle flap