Microvascular gastrocnemius muscle transfer to the distal leg using saphenous vein grafts

The gastrocnemius muscle has been transferred to the distal leg by lengthening its vascular pedicle with interposition saphenous vein grafts. This procedure is presented as an alternative to free-flap transfers requiring vein grafts to the proximal leg. By increasing the arc of rotation of the gastrocnemius muscle with vein grafts, the full dimensions of the muscle can be used to cover large prepatellar, suprapatellar, and distal leg defects.