Flap reconstruction of the knee: A review of current concepts and a proposed algorithm

Figure 1 A 28-year-old man suffered a postburn unhealed wound around the right knee that was managed with pedicled gastrocnemius flap. A: The exposed patella was associated with flexion contracture; B: A medial gastrocnemius muscle flap was elevated as an island flap based on the medial sural artery. The muscle was freed from its origin and its motor nerve, as well, to allow greater arc of rotation; C: Four weeks postoperatively, gait without external supports was achieved. From the cosmetic point of view, although the muscle was denervated, a bulky pivot point was present that resulted in a cosmetic deformity.