The gastrocnemius muscle flap in the correction of severe flexion contracture of the knee.

Extreme flexion contracture of the knees due to extra-articular contracture of the knee joints is a frequent deformity in catastrophic neurological lesions such as multiple sclerosis, meningomyelocoele, paraplegia, quadriplegia, and cerebral spastic paralysis. Such gross knee contractures together with the coexisting hip flexion contractures create a severe nursing problem. Adequate perineal hygiene and positioning are very difficult to achieve and thus pressure sores frequently develop in these bed-ridden patients in spite of devoted nursing care. The orthopaedic surgeon can help alleviate the plight of these unfortunate victims: first the hip joint contractures are released by the classical methods and then, at the same session, the knee contractures: a simple one stage procedure is described. Primary cover of the large popliteal skin defect is achieved by a gastrocnemius versatile muscle flap, which is itself covered by a free split skin graft. An illustrative case is described.