Pedicled Rotational Medial and Lateral Gastrocnemius Flaps: Surgical Technique

Gastrocnemius flaps have been used for decades to reconstruct defects of the proximal tibia and knee. They have proven to be useful in the soft-tissue reconstruction of defects caused by trauma, tumors, and infections about the knee, and the reconstruction of extensor mechanism discontinuity with and without total joint arthroplasty. The flaps have low failure rates and a distinct proximally based blood supply that allows them to be elevated and rotated up to 15 cm above the level of the knee joint. The vascular anatomy is reproducible because rotational flaps do not require microvascular anastomosis. An understanding of the applied surgical anatomy, approaches, and utility of the gastrocnemius flap makes the technique a useful tool for the orthopaedic surgeon when plastic surgery assistance is not readily available.