title: Microsurgical Reconstruction of Traumatic Lower Extremity Defects in the Pediatric Population.
abstract: BACKGROUND
  Few reports focus exclusively on microsurgical reconstruction of traumatic lower extremity defects in children. Hence, the authors felt it prudent to contribute to this area of clinical research. The authors hypothesized that reconstructive success would be comparable to success rates reported in adults, and that young age or concerns regarding vessel size or behavior do not negatively impact surgical outcome.
  
  
  METHODS
  A retrospective review of microsurgical lower extremity reconstruction cases at two academic medical centers was performed. All pediatric patients who underwent microsurgical reconstruction of traumatic lower extremity defects between 1997 and 2012 were included for analysis.
  
  
  RESULTS
  Forty flaps transferred in 40 patients with a mean age of 11.4 years (range, 1 to 17 years) were included for analysis. Muscle flaps were predominantly used [n = 23 (57.5 percent)]; however, there was a recent increase in use of fasciocutaneous flaps [n = 16 (40 percent)]. Postoperative complications were seen in 25 percent of patients, with a total flap loss rate of 5 percent. No donor-site complications were observed. The mean postoperative length of hospital stay was 12.9 days (range, 4 to 41 days), with patients returning to full weight-bearing after a mean of 2.6 months (range, 1 to 8 months).
  
  
  CONCLUSIONS
  Microsurgical reconstruction of traumatic lower extremity defects in the pediatric population is safe. Concerns related to patient age, vessel size, or vessel behavior (i.e., vasospasm) should not detract from offering free flap reconstruction, as they do not negatively impact outcomes.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Palo Alto, Calif.; and Philadelphia, Pa.|From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center; and the Division of Plastic Surgery and the Department of Orthopedic Surgery, University of Pennsylvania Health Systems.
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.affiliation: Palo Alto, Calif.; and Philadelphia, Pa.|From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center; and the Division of Plastic Surgery and the Department of Orthopedic Surgery, University of Pennsylvania Health Systems.
authors.forename: Michael
authors.initials: M
authors.lastname: Lanni
authors.affiliation: Palo Alto, Calif.; and Philadelphia, Pa.|From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center; and the Division of Plastic Surgery and the Department of Orthopedic Surgery, University of Pennsylvania Health Systems.
authors.forename: L Scott
authors.initials: LS
authors.lastname: Levin
authors.affiliation: Palo Alto, Calif.; and Philadelphia, Pa.|From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center; and the Division of Plastic Surgery and the Department of Orthopedic Surgery, University of Pennsylvania Health Systems.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kovach
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps