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Original Article Plastic and Aesthetic Research

Anatomic variability of the vascularized

composite osteomyocutaneous fl ap from

the medial femoral condyle: an anatomical

study

2
1
3
Trung-Hau Lê Thua , Duc-Phu Bui , Dang-Nhat Pham , Vu-Bao Lê , Albert De Mey ,
1
4
Willy Boeckx 4
1 Department of Plastic, Reconstructive and Hand Surgery, Hue Central Hospital, Hue City 47000, Thừa Thiên–Huế, Vietnam.
2 Departments of Surgery, Hue University of Medicine and Pharmacy, Hue City 47000, Thừa Thiên–Huế, Vietnam.
3 Department of Surgery, An Sinh Hospital, Ho Chi Minh City 70000, Vietnam.
4 Department of Plastic Surgery, Brugmann University Hospital, Free University of Brussels, Brussels 1020, Belgium.
Address for correspondence: Dr. Trung-Hau Lê Thua, 55 Tran Nguyen Han Street, Thuan Hoa Ward, Hue City 47000, Thừa Thiên–Huế,
Vietnam. E-mail: donabirini@yahoo.com

ABSTRACT
Aim: The anatomical study and clinical application for the vascularized corticoperiosteal fl ap from the
medial femoral condyle have been performed and described previously. Although prior studies have
described the composite osteomyocutaneous fl ap from the medial femoral condyle, a detailed analysis
of the vascularity of this region has not yet been fully evaluated. Methods: This anatomical study
described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens.
Results: The descending genicular artery (DGA) was found in 33 of 40 cases (82.5%). The superomedial
genicular artery (SGA) was present in 10 cases (25%). All 33 cases (100%) of the DGA had articular
branches to the periosteum of the medial femoral condyle. Muscular branches and saphenous branches
of the DGA were present in 25 cases (62.5%) and 26 cases (70.3%), respectively. Conclusion: The current
study demonstrates that the size and length of the vessels to the medial femoral condyle are suffi cient
for a vascularized bone fl ap. A careful preoperative vascular assessment is essential prior to use of
the vascularized composite osteomyocutaneous fl ap from the medial femoral condyle, because of the
considerable anatomical variations in different branches of the DGA.
Key words:
Descending genicular artery, medial femoral condyle, osteomyocutaneous fl ap, superomedial
genicular artery

INTRODUCTION flap from the medial femoral condyle have been
performed and described previously. [2,3] In 1991, Sakai
The vascularized bone graft is the gold standard for and Doi and Sakai [4,5] initially reported the use of a thin,
reconstruction of bony defects, especially in case of free vascularized corticoperiosteal graft for the treatment
chronic nonunion. An anatomical studies and clinical of persistent nonunion without significant bony defects
[1]
applications for the use of a vascularized corticoperiosteal in the upper limb. It has been demonstrated that the
articular branch of the descending genicular artery (DGA)
Access this article online or the superomedial genicular artery (SGA) perfuses the
Quick Response Code: medial femoral condyle. There are also two branches from
Website: the DGA which supply the muscle and skin at the level
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of the medial femoral condyle; the saphenous branch (SB)
supplies the skin at the medial knee and proximal third
DOI: of the leg, and the muscular branch (MB) normally runs
10.4103/2347-9264.143544 into the vastusmedialis muscle. [4-7] This may allow the
use of the DGA and its branches to form a composite
Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014 85