In severe extremity trauma, selecting the recipient vessel for a free flap is critical. The popliteal artery is often chosen to avoid the zone of injury. In this study, we reviewed nine cases where the popliteal artery was used as the recipient vessel via a medial approach in the supine position. A medial midline incision from the distal thigh to the proximal leg in the supine position allowed adequate exposure of the popliteal artery, and anastomosis with the vascular pedicle of the flap. Compared to the common posterior approach in the prone position, this approach was more efficient because it did not require repositioning of the patient. Flap elevation and recipient vessel preparation could be performed simultaneously. Our findings suggest the effectiveness of the medial approach to the popliteal artery in the supine position.
