Medial Femoral Condyle Free Flap in Head and Neck Reconstruction

Introduction: Free flaps are considered the best reconstructive technique for bony defects in the head and neck. For larger defects (> 5 cm) the most popular free flaps are fibula, scapula and iliac crest. For smaller defects (<3-4 cm) non-vascularized bone graft are a good reconstructive option, if the vascularization of the recipient site is not compromised. Our goal was to demonstrate how the MFC (Medial Femoral Condyle) free flap is a valid reconstructive technique for small defects, when the recipient site was compromised by previous surgical procedures, infection and/or radiotherapy.

Material and Methods: Between October 2012 and June 2017, 12 patients underwent reconstruction of defects of the head and neck with microvascular MFC. The recipient sites were the mandible (4), the maxillary bone (3), the palate (1), the nasal septum (3) and the skull bone (1). Cortico-periosteal and cortico-spongious free flaps were harvested, with an average size of 6,8 cm².

Results: At one-year follow-up, the functional and aesthetic results were assessed as good or very good. In all cases it was possible to faithfully fill the cervical-facial defect. We had only two complications: flap necrosis in one patient and a donor site persistent hypesthesia in another case.

Conclusions: In our experience, the MCF free flap demonstrated high versatility with a low donor site morbidity. We can assert that MFC flap is a new and refined technique for reconstructing small defects in poorly vascularized transplant recipient sites in the head and neck district.