Z-LENGTHENING AND GASTROCNEMIUS-MUSCLE FLAP IN THE MANAGEMENT OF SEVERE POSTBURN FLEXION CONTRACTURES OF THE KNEE

Five patients with seven severe flexion contractures after burn were t reated. The problems confronted at the time of release of these contra ctures were bowstringing of contracted neurovascular bundles and hamst ring tendons. These problems were overcome by Z-lengthening of tendons to achieve nearly normal extension. The medial head of the gastrocnem ius muscle and local adipofascial flaps were used for coverage of expo sed tendons and neurovascular bundles. Complete correction with full r ange of active motion of the knee joint was achieved in all of the pat ients after physiotherapy with no significant complication. We recomme nd this procedure routinely for patients with severe postburn flexion contractures of the knee with shortened tendons and neurovascular bund les.