Femur Fracture Following Medial Femoral Condyle Flap Harvest: A Case Report

: Medial femoral condyle (MFC) corticoperiosteal free flap is a versatile flap that has been gaining popularity in maxillofacial surgery. Its relatively consistent anatomy, ease of harvest and low morbidity of the donor site make it a viable option when a small, well-vascularised piece of corticocancellous bone is needed. So far there have been only three reports of femoral fracture following an MFC free flap harvest. We present the case of a 90-year-old female patient with squamous cell carcinoma of the maxilla alveolar ridge, where a 4 × 2 cm MFC free flap was used for reconstruction of the defect after ablative surgery. On the third postoperative day, while the patient was lying in bed – prior to any attempt of patient verticalization – a femur fracture occurred at the donor site, requiring a surgical fixation of the femur. This is a highly uncommon complication; however, it should be taken into consideration when operating on elderly female patients. It is thus of utmost importance to stay well below the femur shaft when harvesting an MFC free flap in such patients.