Medial Femoral Condyle Flap as Salvage for Osteomyelitic Clavicle Nonunion

Summary: Clavicle nonunion with osteomyelitis is a challenging condition, combining bone infection and structural defects. Traditional 2-stage procedures address these issues but may be unsuitable for patients unable to undergo multiple operations. The medial femoral condyle (MFC) flap has emerged as an effective option, offering both vascularized bone grafting and mechanical support in a single-stage approach, integrating infection control and bone reconstruction. We report a 21-year-old man with right clavicle nonunion and osteomyelitis following internal fixation for a fracture sustained in a motorcycle accident. He presented with soft tissue defects, exposed implants, and signs of infection confirmed through clinical and radiological findings. Although a 2-stage procedure was recommended, the patient declined further surgery due to financial and personal reasons. A single-stage approach was performed, involving debridement, sequestrectomy, and an MFC flap with a corticocancellous bone graft measuring approximately 8 -2.5cm, within the safe harvest limits. Clavicle fixation was achieved with a K-wire. Follow-ups at 1, 3, and 5 weeks showed no infection. Bone union was confirmed at 5 months, and the K-wire was removed. This case highlights the successful use of a single-stage MFC flap for managing clavicle nonunion with osteomyelitis. It demonstrates that combining infection control and bone reconstruction in a single surgery can be an effective alternative to multistage procedures.