Medial femoral condyle free flap for reconstructions of medication related osteonecrosis of the jaw

Medication-related osteonecrosis of the jaw (MRONJ) is a rare complication of antiresorptive therapy that may require free tissue reconstruction. A 57-year-old woman with metastatic breast cancer developed refractory mandibular MRONJ after intravenous zoledronic acid and underwent reconstruction with a medial femoral condylar (MFC) free flap. She recovered without complications and maintained normal function at two-year follow-up. This case supports the MFC free flap as a viable option for small, partial-thickness mandibular defects in selected patients with MRONJ.