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Pediatric Lower Extremity Lawnmower Injuries Requiring Free Tissue Transfer
Caleb W Brown1, Brianna M Elam2, Ethan R Harris3
1From the Department of Surgery, Division of Plastic and Reconstructive Surgery, Quillen College of Medicine, East Tennessee State University, Johnson City, TN.
Insights
Pediatric lawnmower injuries often cause severe lower extremity tissue loss, necessitating advanced reconstruction. Free tissue transfer (FTT) is a crucial option for complex cases, improving outcomes in pediatric patients.
Area of Science:
- Orthopedic Surgery
- Pediatric Trauma
- Reconstructive Surgery
Background:
- Pediatric lower extremity lawnmower injuries are high-energy traumas.
- These injuries frequently involve severe composite tissue loss, increasing amputation risk.
- They often require complex reconstructive procedures.
Abstract:
Pediatric lower extremity lawnmower injuries are high-energy traumas that often result in severe composite tissue loss and require advanced reconstruction. Compared with other mechanisms of pediatric lower extremity trauma, these injuries have a higher incidence of amputation and complex reconstruction. This case series describes 3 pediatric patients, aged 2.5-10 years, who sustained severe lower extremity lawnmower injuries that were managed with free tissue transfer (FTT). Reconstructions included a tensor fasciae latae perforator flap, a latissimus dorsi myocutaneous flap, and an anterolateral thigh perforator flap. These cases demonstrate the practical importance of early escalation to FTT, judicious reconstructive timing, appropriate flap selection between fasciocutaneous and musculocutaneous options, recognition of the indications and limitations of preoperative vascular imaging, and consideration of the unique perioperative challenges associated with FTT.
