The adipofascial flap of the lower leg based on the saphenous artery is a modification of the saphenous artery flap. It has been used successfully in 5 patients for reconstruction of soft tissue defects around the knee and superior third of the tibia. The size of these flaps ranged from 5 x 12 cm to 5 x 18 cm. All flaps survived completely. These cases had minimal donor site morbidity because their donor sites were closed primarily with the preserved overlying skin.