Systematic Review of Free Tissue Transfer Used in Pediatric Lower Extremity Injuries

Mehul Thakkar, MBBS; Bartlomiej Bednarz, MBBS, MA(Cantab)


ePlasty. 2021;21:e2 

In This Article


With evidence of improved success rates, free tissue transfer has become a popular choice in reconstruction of pediatric lower extremity injuries. This study shows that perforator/fasciocutaneous flaps have recently become a more popular choice over muscle flaps. Overall success rate of free flaps is high (95.5%) and comparable with the adult population. The majority of flaps are used to reconstruct defects distal to ankle region, followed by the leg, indicating injury patterns and areas redundant to local/regional flap options. There is a plethora of flaps available to the reconstructive surgeon, and flap selection should be individually tailored depending on the skill, experience, and repertoire of the surgeon and the defect presented in order to ultimately achieve the final goal of restoring optimal function. With this in mind, future studies should take into account functional outcomes and patient-reported outcomes in order to paint a better picture of the success or failures of reconstruction in this population of patients.