We describe a U-shaped approach to the distal femur which, having divided t
he extensor mechanism and elevated the entire quadriceps muscle, gives exce
llent exposure and allows a number of reconstructive options. It was used i
n 14 patients, 13 of whom were followed up for a mean of 3.5 years (1 to 11
). There was no case of flap necrosis, and complications related to the rec
onstruction were acceptable.