Medial Femoral Trochlea Osteochondral Flap: Applications for Scaphoid and Lunate Reconstruction

Abstract

Vascularized osteochondral flaps are a new technique described for the reconstruction of challenging articular defects of the carpus. The medial femoral trochlea osteochondral flap is supplied by the descending geniculate artery. This osteochondral flap has shown promise in the treatment of recalcitrant scaphoid proximal pole nonunions and advanced avascular necrosis of the lunate. The anatomy, surgical technique, and results are discussed, with clinical cases provided.

Keywords: Descending geniculate artery; Kienböck disease; Medial femoral condyle; Medial femoral trochlea; Osteochondral flap; Scaphoid nonunion; Vascularized bone.