9세 이하 소아에서의 외측과상부 지방근막 피판술

Purpose: To report relatively long-term clinical results of lateral supramalleolar adipofascial flap for children who injured soft tissue on the dorsum of the foot and ankle, a condition that readily gives rise to contracture and deformity in that area. Materials and Methods: This report presents the authors’ experience with eleven patients treated with this flap. The patients’ages ranged from three to nine years; three of the patients were male and eight were female. The major cause of the soft-tissue defects involved acute crushing injury from a traffic accident. The flap and the adjoining raw area were covered with a full-thickness skin graft after 5-7 days postoperatively, and the donor site at the lateral aspect of the leg was closed primarily without grafting. A skin graft was taken from the groin area, which was closed primarily. Results: All flaps survived, and there were no major complications. No patients showed contracture at the recipient site or deformity of the foot and ankle. Compared with the other flaps, this adipofascial flap was thinner, produced less bulkiness at the recipient site, and caused only minor aesthetic sequelae at the donor site. None of the patients in this study complained of contracture and limitation of motion of the metatarso-phalangeal joint, which might be disturbed by wearing shoes or walking. Conclusion: The relatively long-term clinical result of a lateral supramalleolar adipofascial flap for children who sustain soft tissue defects on the dorsum of the foot and ankle is satisfactory.