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The corticoperiosteal medial femoral supracondylar flap: anatomical study for clinical evaluation in mandibular osteoradionecrosis

  • Anatomic Bases of Medical, Radiological and Surgical Techniques
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Abstract

Purpose

An ideal way to treat osteoradionecrosis of the jaws is to transfer an osteogenic, appropriately vascularized flap to the affected site. The corticoperiosteal femoral medial supracondylar flap is being used increasingly in the treatment of complex pseudarthrosis of long bones, but is yet to find robust indications for use in the treatment of osteoradionecrosis of the jaw, the reasons being a lack of anatomical data concerning its vascular supply and the local constraints of its routine harvest. This study presents an anatomical study and literature review to explore its potentials in clinical practice.

Materials and methods

A total of 25 legs were dissected following vascular injection of colored neopren. The descending genicular artery (DGA) and veins were studied with particular attention paid to anatomical variations found in their branches. Calibers and length of the vessels were recorded.

Results

Many anatomical variations of the DGA were found and a classification proposed. The mean caliber of the DGA at the origin was 1.9 mm, and for the vein, 1.8 mm. The mean useful length of the pedicle was 7.9 cm. A case is reported.

Conclusion

A clear anatomical knowledge (and, therefore, a sound classification system to grade flap harvesting potential) is the key first step prior to extensive clinical use of this flap. Various anatomical patterns of the pedicle are frequently encountered; branches can be elusive when raising the flap. Vascular imaging is therefore a critical step in identifying types and subtypes before surgery.

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Authors and Affiliations

  1. Department of Anatomy, Faculty of Medicine, Toulouse-Purpan, 133 Route de Narbonne, 31062, Toulouse-Cedex, France

    Guillaume Dubois, Raphael Lopez & Frederic Lauwers

  2. Department of Maxillofacial Surgery, Purpan Hospital, TSA 40031, 31059, Toulouse Cedex 9, France

    Guillaume Dubois, Raphael Lopez, Leslie Noyelles & Frederic Lauwers

  3. Nuffield Department of Surgery, John Radcliffe Hospital, Oxford, OX3 9DU, UK

    Prasanna Puwanarajah

Authors
  1. Guillaume Dubois
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  2. Raphael Lopez
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  3. Prasanna Puwanarajah
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  4. Leslie Noyelles
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  5. Frederic Lauwers
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Correspondence to Guillaume Dubois.

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Dubois, G., Lopez, R., Puwanarajah, P. et al. The corticoperiosteal medial femoral supracondylar flap: anatomical study for clinical evaluation in mandibular osteoradionecrosis. Surg Radiol Anat 32, 971–977 (2010). https://doi.org/10.1007/s00276-010-0658-9

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  • DOI: https://doi.org/10.1007/s00276-010-0658-9

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