{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:01:59Z","timestamp":1753869719300,"version":"3.41.2"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Pathological fractures associate a complex tumoral microenvironment that can culminate in a complex bone nonunion. Surgical treatment with vascularized periosteal flaps has resulted into an excellent option in children because of their angiogenic and osteogenic properties; nonetheless, it has been scarcely reported in the adult. We present a case report that challenges the classical concept of not using pure periosteal flaps in the adult, widening surgical options for nonunion. A 67\u2010year\u2010old male patient diagnosed with multiple myeloma presented nonunion after pathological fracture in the left humerus. He was treated with a pedicled lateral humeral pure periosteal flap based in the posterior collateral radial vessels. It measured a 6\u2009cm\u2009\u00d7\u20094\u2009cm and was pedicled proximally, wrapping it around the nonunion site after compression plate osteosynthesis. Post operatory was uneventful and the patient was followed 9\u2009months after surgery. Periosteal callus and bony bridges were formed 4\u2009months after surgery. This case avoids the need of a free flap such as the Sakai, with conservation of the advantages of the cambium layer such as demonstrated in children.<\/jats:p>","DOI":"10.1002\/micr.70034","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T15:30:02Z","timestamp":1743175802000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lateral Humeral Pure Periosteal Flap for Nonunion of Humerus Pathologic Fracture in an Elderly Patient: A Case Report"],"prefix":"10.1002","volume":"45","author":[{"given":"Javier","family":"Buend\u00eda Perez","sequence":"first","affiliation":[{"name":"Chief of Department of Reconstructive and Aesthetic Plastic Surgery Hospital Cl\u00ednico San Carlos  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8767-1440","authenticated-orcid":false,"given":"Beatriz","family":"Iniesta","sequence":"additional","affiliation":[{"name":"Department of Reconstructive and Aesthetic Plastic Surgery Hospital Cl\u00ednico San Carlos  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Asensio Ramos","sequence":"additional","affiliation":[{"name":"Department of Reconstructive and Aesthetic Plastic Surgery Hospital Cl\u00ednico San Carlos  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Soldado","sequence":"additional","affiliation":[{"name":"Pediatric Hand Surgery and Microsurgery Unit, HM Nens Instituto de Investigaci\u00f3n Sanitaria HM Hospitales  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"issue":"8","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1016\/j.jse.2020.10.024","article-title":"Morbidity and Mortality of Surgically Treated Pathologic Humerus Fractures Compared to Native Humerus Fractures","volume":"30","author":"Amen T. 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