48yo male pt who had had an Gustilo IIIb open fracture of the left patella and lateral tibial plateau, including a large loss of soft tissue and most of the lateral femoral condyle. A soft tissue vascularized flap was needed to cover the defect.

The surgical steps were:

-Hardware removal

-Tibial tuberosity osteotomy to enlarge the approach

-Fresh osteochondral allograft transplantation of the LFC

-The lateral fibular ligament and the popliteus tendon was kept in the graft, and fixed distally in the fibular head and in the posterolateral corner of the tibia, respectively.

-The TT was fixed back

-Postoperatively, the patient was non-weightbearing for 3 months, and full ROM was encouraged from day 1.