title: Free groin flap for recurrent severe contractures of the neck in children.
abstract: BACKGROUND
  Severe post burns contracture in children not only leads to functional impairment but also has profound psychological impact on the child. Untreated neck contractures have been shown to inhibit mandibular growth. Skin grafting in children has a higher rate of recurrence and in these cases a thin pliable flap seems to provide a durable solution.
  
  
  OBJECTIVE
  To study the feasibility of using primarily thinned free groin flap in the treatment of recurrent neck contractures in children.
  
  
  METHODS
  Five patients, in the age group of 5-10 years, with recurrent neck contractures and operated between 2005 and 2008 were included in this study. The sternomental distance, lateral flexion angle and cervicomental angle were measured preoperatively, postoperatively and during the subsequent follow-up visits. The patients were followed up for a period between 1 and 3 years with a mean of 29 months.
  
  
  RESULTS
  All the flaps survived. The cervicomental angle improved significantly to 90-105°, the lateral flexion angle improved to 35-45° and the sternomental distance increased considerably.
  
  
  CONCLUSIONS
  Recurrent post burns contracture of the neck in children causes not only functional and aesthetic impairment but also psychological problems. A free microthinned groin flap provides a very attractive solution for this problem and should be seen as an effective alternative in recurrent cases.
authors.affiliation: Department of Plastic Surgery, Specialist Hospital, Kochi, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Ghosh
authors.forename: R
authors.initials: R
authors.lastname: Jayakumar