25.0: Thursday, March 17, 2005

Free Flap Reconstruction of Lower Extremity Trauma in Pediatric Patients

Mary C. Snyder, MD and Venkat K. Rao.

Study Purpose: This study was intended to evaluate outcomes of rectus abdominis and latissimus dorsi free flaps for reconstruction of lower extremity trauma in pediatric patients. Materials and Methods: Eighteen patients with a mean age of 12.6 years underwent free flap reconstruction at the University of Wisconsin for lower extremity trauma from 1988-2004. A chart review and functional testing was conducted to identify etiology, complications, outcomes and donor site morbidity. Results: Motor vehicle accidents accounted for 50% of injuries and lawnmower accidents for 33%. Twelve patients underwent rectus abdominus flap reconstruction; six underwent latissimus dorsi flap reconstruction. Defect size was significantly higher and operative blood loss was significantly lower in the latissimus group as compared to the rectus group; difference in mean operating room time was not statistically significant. Complication rates were low, with one complete flap loss in the rectus group, and one partial loss in the latissimus group. Long-term flap outcomes were equivalent and functional testing of donor site morbidity is pending. Conclusions: Free rectus abdominus and latissimus dorsi flaps are both viable options for lower extremity reconstruction in pediatric patients. They exhibit high success rates and few differences in complication rates and outcomes.