Use of distally pedicled sural fasciocutaneous cross-leg flap in severe foot and ankle trauma: a safe alternative to microsurgery in very young children.

Advances in reconstructive microsurgery have enabled us to make use of many flap alternatives in severe lower-extremity trauma, and traditional cross-leg flaps for wound coverage have been replaced in most centers by free-tissue transfers. But free-flap surgery is still a challenging area in very young pediatric populations because of technical difficulties with considerable drawbacks. Six children with severe foot and ankle trauma were presented. Distally based sural fasciocutaneous cross-leg flaps were carried out to cover the defects, with no complications. Because of its easy dissection and reliable pedicle without compromising the major vessels, this procedure may be a safe choice among the other cross-leg flap alternatives when microsurgery is not considered.