Experience with five patients requiring arterial reconstruction for injury distal to the popliteal trifurcation indicates that such operations are both feasible and valuable. Fractures and associated nerve and venous injury are common but do not preclude successful limb salvage. The importance of early diagnosis and prompt surgical repair is emphasized. Preservation of the ipsilateral saphenous vein and exclusion of vascular anastomoses from the wound are useful technical adjuncts.