FREE GRACILIS MUSCLE TRANSFER FOR COVERAGE OF SEVERE FOOT DEFORMITIES

The purpose of this study was to describe the gracilis free-tissue tra nsfer for soft-tissue coverage after surgical correction of severe clu bfoot and other complex foot deformities in children older than 4 year s. Requirements for success include complete correction of deformity, temporary Kirschner-wire fixation to maintain correction, experience i n microvascular surgery, and close postoperative monitoring of the tis sue transfer. Atrophy of the muscle transfer over the first year precl udes the need for debulking procedures. This procedure was used in thr ee children aged 4.5, 7, and 7.3 years with untreated or recurrent equ inovarus foot deformities. Postoperatively, these children had flexibl e, pain-free, plantigrade feet with no donor-site complications. In co nclusion, the gracilis free transfer appears to be a safe, effective, and reliable option to cover soft-tissue defects after the treatment o f severe clubfeet in older children.