Long-Term Outcomes on Bone Growth Following Reconstruction of the Distal Fibula Using a Pedicled Second Metatarsal Osteomyocutaneous Flap in Children: A Case Report.

CASE REPORT: This report describes a 22-year-old man who sustained a severe left ankle injury caused by a lawnmower at the age of 4 years, resulting in loss of the lateral malleolus. He was treated with a pedicled composite flap using the ipsilateral second metatarsal and was followed until skeletal maturity. A favorable functional outcome was maintained for 15 years.

CONCLUSION

At final follow-up after growth completion, no limb length discrepancy was observed. The ankle was stable, painless, and preserved good range of motion, with no significant donor site morbidity. This surgical technique represents a technically simpler alternative with lower morbidity compared with vascularized proximal fibular epiphyseal transfer for lateral malleolus reconstruction in growing children.