title: Gastrocnaemius-propeller extended miocutanous flap: a new chimaeric flap for soft tissue reconstruction of the knee.
abstract: OBJECTIVE
  Soft tissue defects involving the anterior aspect of the knee are a frequent finding in a number of pathological conditions. The aim of this article is to describe a new pedicled flap consisting of a conventional medial gastrocnaemius muscle flap associated with a propeller flap based on a perforator of the medial sural artery.
  
  
  METHODS
  Five males ranging in age between 26 and 72 years underwent a reconstruction of the soft tissue of the knee by means of the described procedure. Three patients sustained complex tissue loss subsequent to high-energy trauma; two losses were due to septic complications after elective knee surgery.
  
  
  RESULTS
  Four flaps survived allowing adequate proximal tibial metaphysis and patella coverage. One patient underwent early above-the-knee amputation due to life-threatening septicaemia.
  
  
  CONCLUSIONS
  The described chimaera flap consists of a medial gastrocnaemius flap with a skin paddle that is elevated on a perforator of the medial sural artery and then rotated according to the propeller flaps' principles. It provides effective coverage of large soft tissue defects of the knee. In the authors' experience, the propeller flap portion proved to be particularly useful to cover the patella, while the muscle flap was used to cover the proximal metaphysis of the tibia and fill the dead space if present.
authors.affiliation: Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Innocenti
authors.affiliation: Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Cardin-Langlois
authors.affiliation: Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Menichini
authors.affiliation: Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy. Electronic address: carlabaldrighi@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Baldrighi
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D007717:Knee / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D064827:Myocutaneous Flap; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery; D016896:Treatment Outcome
keywords: Lower limb reconstruction; Propeller flap; Soft tissue loss around the knee