<s>[INST] Hello doctor, I have a big scar in my right thigh that has led to a contracture with little flexure on my knew joint for over ten years. I have recently underwent a corrective Z-plasty release but with only little gains in flexure, the Doctor said the contracture had develop a fibrosis that needs to be removed. Is there any non-surgical method of releasing fibrotic contracture? [/INST] Hi. From what I can see in the pictures is that you have got a massive tissue loss over your thigh and that too over such a long period that it has gone for severe contracture. Only the Z-plasty will definitely not give you enough results. As your doctor has suggested you will have to go for complete removal of the scar and fibrotic tissue with reconstruction by a large free flap. Before that, few investigations will be required which will give the idea about how much post op benefit u will be gaining. Non-surgical methods are there for removing the fibrosis, but definitely not for such a massive one. X ray of the knee and hip, MRI of thigh region, vascular doppler of donor vessel for a free flap. Scar and fibrosis Excision with reconstruction by free flap </s>