Pedicled chimeric gastrocnemius—medial sural artery adipofascial flap for reconstruction of anterolateral defects of the knee

Abstract

A medial gastrocnemius muscle flap is useful for soft tissue reconstruction of the knee and proximal tibia but insufficient to cover defects involving the lateral aspect of the knee. The purpose of this report is to present the results of the use of a pedicled chimeric gastrocnemius—medial sural artery adipofascial flap for reconstruction of defects of the knee and lateral aspect of the knee. Six patients underwent soft tissue reconstruction of the knee by means of the described procedure. Patients included one female and five males. The mean age of the patients was 48 years. The cause of soft tissue defects was open fractures in three cases and infection in three cases. The mean size of soft tissue defects was 9.3 × 7 cm (range: 6 × 3 to 18 × 14 cm), and the mean size of adipofascial components was 6.8 × 3.8 cm (range: 6 × 3 to 10 × 6 cm). Medial knee defects were covered by the medial gastrocnemius muscle component and lateral knee defects were covered by the medial sural artery adipofascial component. All flaps survived in the six cases. Soft tissue reconstruction and infection control were successful without any additional surgical procedures. A pedicled chimeric gastrocnemius–medial sural artery adipofascial flap may be considered effective for soft tissue reconstruction of the knee as it reduces scars at the donor site and reconstructs the lateral knee defects not covered by the medial gastrocnemius muscle flap. © 2015 Wiley Periodicals, Inc. Microsurgery 37:206–211, 2017.