Knee salvage utilizing the myocutaneous principle

Two cases are presented to illustrate the potential for knee salvage in popliteal artery occlusion from plateau fracture. In both cases, the time interval from injury to exploration precluded revascularization of the lower leg. Because of the necrosis of the deep leg muscles and the nonvital nature of the foot, amputation was required. Careful evaluation of the myocutaneous circulation of the gastrocnemius skin island provides a means of knee salvage. Extensive debridement, salvage of the tibial fragment as a bone graft, and coverage with the vital gastrocnemius and its skin provide a functioning below-the-knee stump that can be fitted with a prosthesis. In this way, a more satisfactory functional result and rehabilitation can be obtained than with an above-the-knee amputation.