Reconstruction of Foot and Ankle Defects with a Free Anterolateral Thigh Flap in Pediatric Patients

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dc.contributor.authorAcar, Mehmet Ali
dc.contributor.authorGulec, Ali
dc.contributor.authorAydin, Bahattin Kerem
dc.contributor.authorErkocak, Omer Faruk
dc.contributor.authorYilmaz, Guney
dc.contributor.authorSenaran, Hakan
dc.date.accessioned2020-03-26T19:06:52Z
dc.date.available2020-03-26T19:06:52Z
dc.date.issued2015
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractBackground There are a limited number of published studies describing reconstruction with an anterolateral thigh (ALT) flap following lower extremity injury in pediatric patients. The aim of this study was to present our experiences with the application of a free ALT flap not only in the reconstruction of soft tissue defects around the pediatric foot arid ankle but also in patients with bone, tendon, and ligament injuries that require repair. Materials and Methods Reconstruction with a free ALT flap was performed in 11 pediatric patients (mean age, 8.9 years; range, 3-15 years) between November 2010 and February 2013. The modes of injury were as follows: six traffic accidents, three firearm accidents, one agricultural machinery accident, and one bicycle chain accident. A retrospective evaluation of the applied surgical procedures was performed: flap size, perforator type and number, placement area, site of anastomosis, closure of the donor site, complications, and flap survival. Results The mean size of the skin flap was 83.2 mm(2) (range, 48-117 mm(2)). Except for two patients, there were two perforators in the obtained flaps, which were 75% musculocutaneous and 25% septocutaneous. To strengthen the Achilles tendon in one patient, the ALT, together with the fascia lata, was raised as a composite flap. This flap was used as a "sensate flap" in three patients with defects in the heel area and as a "perforator flap" in seven patients. Anastomosis was performed in the anterior tibial artery in five patients and in the posterior tibial artery in six patients. Primary closure was performed for the donor site in all patients. Due to venous thrombus after 24 hours in one patient, reexploration was performed, and blood flow was regained with a vein graft. In the same patient, partial necrosis developed on the lateral edge of the flap; after debridement of the necrotic areas, closure was performed with a split thickness skin graft. After the ALT flap procedure, the primary flap survival rate was 90.9%. Conclusion The free ALT flap could be a safe, reliable, and aesthetically appealing option for foot/ankle resurfacing in children after traumatic soft tissue loss. The ALT flap can cover a far greater area and provide the versatility needed to optimize soft-tissue coverage.en_US
dc.identifier.doi10.1055/s-0034-1395888en_US
dc.identifier.endpage232en_US
dc.identifier.issn0743-684Xen_US
dc.identifier.issn1098-8947en_US
dc.identifier.issue3en_US
dc.identifier.pmid25629205en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage225en_US
dc.identifier.urihttps://dx.doi.org/10.1055/s-0034-1395888
dc.identifier.urihttps://hdl.handle.net/20.500.12395/32494
dc.identifier.volume31en_US
dc.identifier.wosWOS:000350188800010en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTHIEME MEDICAL PUBL INCen_US
dc.relation.ispartofJOURNAL OF RECONSTRUCTIVE MICROSURGERYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectfoot and ankleen_US
dc.subjectfree anterolateral thigh flapen_US
dc.subjectpediatric reconstructionen_US
dc.subjecttraumaen_US
dc.titleReconstruction of Foot and Ankle Defects with a Free Anterolateral Thigh Flap in Pediatric Patientsen_US
dc.typeArticleen_US

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