TENDON TRANSFER WITH A MICROVASCULAR FREE-FLAP FOR INJURED FEET IN CHILDREN

We reviewed 11 patients who had been treated between January 1986 and June 1994 for severe foot injuries by tendon transfer with microvascul ar free flaps. Their mean age was 5.6 Sears (3 to 8). Five had simulta neous tendon transfer and a microvascular free flap and six had separa te operations. The mean interval between the tendon transfer and the m icrovascular free flap was 5.8 months (2 to 15) and the mean time betw een the initial injury and the tendon transfer was 9.6 months (2 to 21 ). The anterior tibial tendon was split in five of six cases. The post erior tibial tendon was used three times and the extensor digitorum lo ngus tendon twice. The mean follow-up was 39.7 months (24 to 126). The re were nine excellent and two good results. Postoperative complicatio ns included loosening of the transferred tendon (2), plantar flexion c ontracture (1) mild flat foot deformity (1) and hypertrophic scars (2) . We recommend tendon transfer with a microvascular free flap in child ren with foot injuries combined with nerve injury and extensive loss o f skin, soft tissue and tendon.