title: [Long-term functional evaluation of complex traumatic heel defects reconstructed by flap in children].
abstract: BACKGROUND
  Complex heel injuries in children are rare and their management requires coverage combining resistance and thinness, to allow walking and footwear. The objective of this study was to create a decision-making algorithm for heel defect in children.
  
  
  METHODS
  Children received for heel defect, reconstructed with flap in our plastic surgery unit of Bordeaux with a follow-up greater than 10 years were investigated. Three children operated between 1999 and 2003 were included. A free contralateral reinnervated medial plantar flap, a free latissimus dorsi flap and a lateral supramalleolar flap were performed. Patients were reviewed in consultation to assess quality of reconstruction and functional outcomes. Three scores were used, the Foot Function Index (FFI), the AOFAS Ankle and Hindfoot Scale and the Maryland Foot Score.
  
  
  RESULTS
  No growth disorder has been found. Scores greater than 80 for the Maryland Foot Score and AOFAS Ankle and Hindfoot Scale and less than 10 for the FFI were very satisfactory in cases 1 and 3. We found pain and greater functional impairment in the second case.
  
  
  CONCLUSIONS
  "Like-with-like" reconstruction remains the gold standard, whether in loco-regional or free flap. The fasciocutaneous flaps allow custom reliable coverage with little donor site morbidity. Loco-regional flaps remain easily accessible but donor site sequelae are not negligible.
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main et du poignet, centre François-Xavier-Michelet, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France. Electronic address: tiphaine.menez@chu-bordeaux.fr.
authors.forename: T
authors.initials: T
authors.lastname: Ménez
authors.affiliation: Service de chirurgie plastique reconstructrice et des brulés, CHU de Toulouse Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
authors.forename: B
authors.initials: B
authors.lastname: Chaput
authors.affiliation: Service de chirurgie plastique, hôpital Roger-Salengro, CHU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Bonte
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main et du poignet, centre François-Xavier-Michelet, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Alet
authors.affiliation: Service de chirurgie plastique reconstructrice et des brulés, CHU de Toulouse Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Grolleau
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main et du poignet, centre François-Xavier-Michelet, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Michot
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main et du poignet, centre François-Xavier-Michelet, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Pélissier
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery; D000465:Algorithms; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D000069836:Degloving Injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000294:innervation; D006365:Heel / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D011183:Postoperative Complications / Q000209:etiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012421:Rupture; D013524:Surgical Flaps
keywords: Child; Defect; Enfant; Heel; Lambeau plantaire médial; Perte de substance; Plantar medial flap; Reconstruction; Talon