A solid microsurgical technique for vascular microanastomosis
and nerve coaptation enables a good nerve and vessel healing, perhaps partly explaining our BMD findings in our patients.
Autologous cancellous bone graft has been considered more osteogenic as compared to cortical bone graft because the presence of spaces within their structure, allows the diffusion of nutrients and limited revascularization by microanastomosis
of its circulating vessels (10-12).
In fact, Kolker is correct when he states, "the decision to perform free flap microanastomosis
to clearly uninjured vessels proximal to the zone of injury [sic] must be weighed against the anatomic and technical difficulties of performing such an anastomosis.
In addition, while endoscopic microanastomosis
(microsurgery to connect blood vessels in transplantation of tissue using an endoscope) was successful, open microanastomosis
using a microscope was not.