OBJECTIVETo investigate the blood supply and the clinical application of the posterior calf fasciocutaneous flap for repairing the frontal defect of knee joint.

METHODSBased on the article review and the anatomical study of the posterior calf in 8 cadavers (16 sides), 10 cases with frontal defects of knee joints were repaired with island fasciocutaneous flaps which had pedicles of lateral superficial sural artery and the lateral sural nerve.

RESULTSThe anatomical study showed there were three systems of superficial sural blood supply- medial, middle and lateral systems. They are originated from popliteal artery or from the bilateral sural artery. The lateral superficial sural artery was present in 100% of the cadavers. The flaps survived completely in 9 cases, except one case with partial necrosis at the one-fourth distal end of the flap. The patients were followed up for 6-12 months with good aesthetic and functional results.

CONCLUSIONSThe posterior calf island fasciocutaneous flap has an reliable blood supply and protective sense nerve. The flap is ideal for the reconstruction of soft tissue defect around knee joint.