Free and Island Flap Transfers for the Treatment of Motor Vehicle Injuries

ABSTRACT

Thirteen patients (10 males and 3 females; age range at surgery: 2 to 41 years, average: 13.5 years) with motor vehicle injuries of the foot (n = 10) and leg (n = 3) were treated using free and island flaps. Donor flaps consisted of a scapular flap in six cases, a peroneal flap in four, a latissimus dorsi musculocutaneous flap in one, gracillis muscle flap in one, and gastrocnemius muscle flap in one case. Free grafts were transferred in 10 patients and pedicle grafts in three. All flaps survived completely. Moderate scarring was noted in two patients who underwent scapular flap transfer, and growth disturbances occurred in two patients with metatarsal fracture accompanying epiphyseal plate injury. Functionally, no patients experienced any disturbance, and all reconstructed sites were cosmetically satisfactory. Early flap coverage of soft-tissue defects due to motor vehicle injury was shown to be useful from the point of view of both cosmetic and functional results.

KEYWORDS

Avulsion injury - traffic accident - flap - foot - children

REFERENCES

• 1 Ito Y, Doi K, Sakai K, Ihara K, Muramatsu K, Kawai S. Run over injuries of the ankle in the children [in Japanese].  Kossetsu. 1992;  14 171-174
• 2 Nuzumlali E, Gurbuz C, Kantarci U, Cepel S, Bayri O, Polatkan O. Moving car-tire injuries of the foot: reconstruction with microvascular free flaps.  J Reconstr Microsurg. 1996;  12 297-302
• 3 Iwaya T, Harii K, Yamada A. Microvascular free flaps for the treatment of avulsion injuries of the feet in children.  J Trauma. 1982;  22 15-19
• 4 Rajacic N, Lari A R, Khalaf M E, Kersnic M. Free flaps for the treatment of avulsion injuries in the feet.  J Pediatr Orthop. 1994;  14 522-525
• 5 Yamauchi T, Yajima H, Tamai S, Kizaki K. Flap transfers for the treatment of perichondrial ring injuries with soft tissue defects.  Microsurgery. 2000;  20 262-266
• 6 Harii K, Ohmori K, Torii S et al.. Free groin skin flaps.  Br J Plast Surg. 1975;  28 225-237
• 7 Stevenson T R, Mathes S J. Management of foot injuries with free-muscle flaps.  Plast Reconstr Surg. 1986;  78 665-671
• 8 Yoshimura M, Imura S, Shimamura K et al.. Peroneal flap for reconstruction in the extremity: preliminary report.  Plast Reconstr Surg. 1984;  74 402-409
• 9 Gilbert A, Teot L. The free scapular flap.  Plast Reconstr Surg. 1982;  69 601-604
• 10 Hamilton S G, Morrison W A. The scapular free flap.  Br J Plast Surg. 1982;  35 2-7