The use of medial femoral condyle corticoperiosteal flap in the treatment of nonunions of upper and lower limbs

Nonunion is the inability of a bone to heal after a fracture and has a frequency of 5-10%. It is a multifactorial condition, and many elements contribute to causing it (e.g. age, sex, smoking, diabetes and type of trauma). The medial femoral condyle corticoperiosteal flap (MFCCPF) is a valuable treatment for atrophic nonunions of both upper and lower extremity nonunions, both long and short and flat bones. The MFCCPF has advantages such as a high healing rate, low donor site morbidity, versatility, and the possibility of performing with a cartilaginous surface or without venous anastomosis. However, the shortcoming of this flap is the lack of mechanical support and the capability of filling large gaps, hence other surgical solutions in these cases. This narrative review aims to describe the different and multiple indications for this flap. The MFCCPF has undoubted advantages in the treatment of atrophic nonunions of the lower and upper limbs, especially for small defects of the latter. Indeed, MFCCPF has demonstrated a high rate of bone healing and low donorsite morbidity.