Fig. 10. Corticoperiosteal flap.

Case 3. (A) A thin corticoperiosteal flap is harvested from the medial surface of the supracondylar region. The graft is cut with the aid of a chisel (proceeding from distal to proximal to avoid vessel injury). (B) Good vascular supply of the flap after releasing the tourniquet. (C) The medial femoral condylar periosteal flap is smaller and more flexible and may be easily tailored to irregular defects. (D) Subperiosteal resection of two or three 2-mm-wide strips of cortical layer allows easier flap wrapping around the bone graft. (E) The flap is placed around the radius and fixed with wire or nonabsorbable suture, and microvascular anastomosis is subsequently performed to the adjacent vessels.