Use of vascularized corticoperiosteal flap from the femur for reconstruction of the orbit.

The reconstruction of small and thin defects in the orbital area using vascularized cortex is described herein. This vascularized cortex is taken from the medial supracondyle area of the femur because a small, thin, and flexible bone can be harvested. We have treated 5 patients with orbital bony defects that would have been difficult to reconstruct using conventional free bone grafts. All flaps took perfectly, the results were satisfactory, and no functional loss occurred in the donor site. The advantages of this bone flap include rich vascularity, a long vascular pedicle of about 7 cm, easy flap elevation, and the ability to include a saphenous flap. The thinness and flexibility of the bone flap make it a suitable vascularized bone donor site for treating small, flat craniofacial bony defects such as in the orbital area.