BACKGROUND: Post-burn flexion contracture of the knee joint is a disabling condition which interferes with upright posture and bipedal locomotion. Islanded perforator flaps have been used to resurface the tissue defect produced as a result of contracture release. Despite their various advantages, they are limited by an increased tendency to undergo venous congestion. Perforator-plus flaps can be used to overcome this limitation while retaining the merits of islanded perforator flaps.
METHODS: Nineteen patients with post flame burn flexion contracture of the knee joint underwent surgical release and coverage by various local fasciocutaneous perforator-plus flaps. Patients were followed up for 6 months and the various aspects of functional and aesthetic rehabilitation were assessed.
RESULTS: All local fasciocutaneous perforator-plus flaps resurfaced the tissue defect over popliteal fossa with good color and texture match and maintenance of contour. None of the flaps had any significant early or delayed complications (including venous congestion) to necessitate reoperation. All patients were satisfied with the functional and aesthetic outcome.
CONCLUSION: Local fasciocutaneous perforator-plus flaps can be considered as one of the primary treatment modalities for surgical release and reconstruction of post burn flexion contracture of the knee.