Lower limb trauma that results in soft tissue loss and exposure of the knee joint provides a unique challenge. To facilitate soft tissue coverage, knee joint defects are classified as medial, lateral, anterior, posterior, or complex where more than one surface is involved. Soft tissue coverage is provided by a variety of flaps taken usually from the lower limb, from below the knee, or occasionally from the thigh. These may include muscle flaps, myocutaneous flaps, fasciocutaneous flaps, or free flaps. Flap choice depends on the anatomic site of the defect and its extent. Careful consideration of the anatomic situation of the exposed knee joint and an understanding of the exact anatomy and vasculature to the lower limb muscles will allow correct planning to facilitate adequate coverage of the exposed joint. Technical considerations and flap elevation, transposition and closure will enable even the most complex defects to be closed in one stage. Early closure of open knee joint injuries will prevent dessication of exposed articular cartilage and allow early restoration of knee joint function.
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