Experimental study and clinical use of the fasciosteal flap

Thirty-seven domestic rabbits, 4 dogs, and 2 freshly amputated human limbs were divided into three groups as three different models of fasciosteal flaps that were taken from the distal radii or the tibiae. Through the methods of histology, fluorochrome bone labeling, and perfusing stain, it was confirmed that viability of the bone graft can be maintained by blood flow by means of the fascial route. This technique was used for treating eight patients with nonunion of such different fractured sites as the scaphoid, the talus, and so forth or with osteomyelitic tibial defects or both skin and tibial defects. With 8 to 15 months of follow-up, the osteomyelitis cleared uneventfully and the fracture healed. Patients recovered their normal function. We think that there are at least three routes for the blood supply from deep fascia to bone: direct blood supply, blood supply by means of bone membrane, and blood supply by means of the intermuscular septum. We feel that the fasciosteal flap is an ideal random-pattern vascularized bone graft.