The chimeric lateral femoral condyle flap for reconstruction of a long bone defect in the hand

The medial femoral condyle when based on the descending genicular artery (DGA) or superomedial genicular artery (SMGA) has a reputation as an excellent source of a vascularised bone flap, that also allows combinations as a chimeric flap with other soft tissue components including skin perforator flaps for reconstruction of complex defects in the hand. In a similar fashion the superolateral genicular artery (SLGA) supplies the lateral femoral condyle (LFC), that can also support different types of bone flaps including chimeric designs. The pertinent surgical anatomy and flap harvesting techniques are described in detail. A representative case example using a chimeric LFC flap to provide vascularized corticocancellous bone to replace a metacarpal shaft with a perforator flap for sentinel flap monitoring demonstrates the potential versatility of this donor site.