Versatility of gastrocnemius myocutaneous flap in resurfacing knee, upper and middle third leg defects

Background: Reconstructing soft-tissue defects in the proximal, middle thirds of the leg and knee presents a significant challenge due to the pretibial bone’s subcutaneous location and limited local tissue laxity, respectively. These injuries often result from high-energy trauma or oncological resections, frequently leaving critical structures like bone, tendons, or hardware exposed. Gastrocnemius myocutaneous (GMC) flap remains an important option to resurface such defects. Aims and Objectives: (1) The aim of the study was to study the versatility of GMC flap in resurfacing defects around knee, proximal, and mid-third of leg. (2) To know its functional and esthetic outcome. Materials and Methods: This is a retrospective cohort study conducted from 2022 to 2025 on 13 patients with soft-tissue defects requiring flap coverage over the knee, upper, and middle third leg defects. The wounds were resurfaced with GMC flap, and its functional and esthetic outcomes were assessed. Results: All 13 flaps survived completely with complications such as marginal skin necrosis and wound infection noted in 3 flaps, which were managed conservatively. The flap size averaged between 10 × 4 cm and 20 × 7 cm. At final follow-up, patients demonstrated satisfactory limb function and acceptable cosmetic outcome. Conclusion: GMC flap provides to be an excellent option for coverage of knee, upper, and middle third leg defects with very minimal donor site morbidity. This study reinforces its role as a first-line reconstructive choice for such large defects with good functional and esthetic outcome.