Knee joint salvage utilising a plantar musculocutaneous island pedicle flap

A young adult male presented with an open tibia-fibula fracture, extensive circumferential soft tissue loss and exposed bone. Although the fracture sites were stabilised by an external fixator, chronic infection complicated this 2-week-old wound. Treatment by amputation was elected. Local skin alone was inadequate for coverage of a preferred below-knee amputation. As an alternative to above-knee amputation, the patient underwent coverage of a below-knee amputation using a musculocutaneous island pedicle flap of sensate plantar skin and muscle.