Microvascular Free Flap Reconstruction in Pediatric Lower Extremity Trauma: A 10-Year Review

摘要: Background: Limb-threatening wounds of the adult distal lower extremity pose a challenge to microvascular surgeon and are subject sizable body literature. The microsurgical management these injuries in pediatric population has some unique features but not previously been separate study. Methods: A review was performed all patients (<18 years age) who received free flaps for trauma at University Kentucky Medical Center between 1992 2002. Charts were reviewed contacted via telephone given standardized questionnaire. Logistic regression used identify factors predictive worse outcome or complications. Results: Twenty-six (28 flaps) met selection criteria. most common mechanism injury all-terrain vehicle accidents (n = 6), followed by motorcycle accidents, lawnmower injuries, gunshot wounds. latissimus dorsi muscle flap chosen 15 cases, with four other remaining 13 cases. There 12 Gustillo 3B 3C fractures tibia. External fixation 10 cases internal two. Four had bone gap greater than 4 cm. Three successfully treated distraction osteogenesis. postoperative complication rate 62 percent, infection partial skin graft loss being lost. Growth disturbances seen two patients. Patients receiving within 7 days after have statistically significant complications those undergoing procedure beyond first week. Follow-up ranged from 2 11 years, mean follow-up 4.5 years. All limbs salvaged, ambulatory time survey. Conclusions: is role limb-threatening children. If this taken into consideration, high limb salvage good function can be expected.