{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:12:26Z","timestamp":1781323946976,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,8,2]],"date-time":"2017-08-02T00:00:00Z","timestamp":1501632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Small recalcitrant non\u2010unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow\u2010through flap (MFC\u2010ALT flap) and report its use for reconstruction of small non\u2010unions with concomitant large soft tissue defects in three exemplary patients. Two female and one male patients ages 39\u201358 years suffered from composite bone and soft tissue defects of the lower extremity and clavicle caused by tumor resection and postoperative radiation resp. infected tibial pilon fracture. The sizes of the soft tissue defects ranged from 15\u201323 \u00d7 4.5\u20136 cm and the sizes of the bone defects ranged from 1.5\u20134 \u00d7 2\u20134 cm. Defect reconstructions were performed in all cases with sequential chimeric MFC\u2010ALT flaps with sizes ranging from 2\u20134 \u00d7 1.6\u20134 cm for the MFC and 21\u201323 \u00d7 7\u20138 cm for the ALT skin paddles. Functional reconstructions were achieved in all cases resulting in stable unions and soft tissue coverage enabling the patients to bear full weight without assistance on 5\u2010months follow\u2010up. Postoperative course was uneventful and complications were restricted to a small skin necrosis at the suture line in one case. MFC\u2010ALT flaps may be a safe, and effective procedure for one\u2010stage reconstructions of small, irregularly shaped bone defects with concomitant large soft tissue loss or surrounding instable scarring, particularly in cases of recalcitrant non\u2010unions after radiation exposure.<\/jats:p>","DOI":"10.1002\/micr.30209","type":"journal-article","created":{"date-parts":[[2017,8,2]],"date-time":"2017-08-02T13:02:50Z","timestamp":1501678970000},"page":"824-830","source":"Crossref","is-referenced-by-count":14,"title":["Sequential chimeric medial femoral condyle and anterolateral thigh flow\u2010through flaps for one\u2010stage reconstructions of composite bone and soft tissue defects: Report of three cases"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4775-0151","authenticated-orcid":false,"given":"Dominic","family":"Henn","sequence":"first","affiliation":[{"name":"Department of Hand Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed H.","family":"Abouarab","sequence":"additional","affiliation":[{"name":"Department of Hand Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg Heidelberg Germany"},{"name":"Department of Plastic and Reconstructive Surgery and Burns Faculty of Medicine, University of Alexandria Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Hirche","sequence":"additional","affiliation":[{"name":"Department of Hand Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen F.","family":"Hernekamp","sequence":"additional","affiliation":[{"name":"Department of Hand Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker J.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Hand Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Kneser","sequence":"additional","affiliation":[{"name":"Department of Hand Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kremer","sequence":"additional","affiliation":[{"name":"Department of Hand Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2012.05.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1081405"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.03.006"},{"key":"e_1_2_7_5_1","first-page":"379","article-title":"Vascularized bone graft from the supracondylar region of the femur","volume":"29","author":"Doi K.","year":"2009","journal-title":"Microsurgery. 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