The use of bilateral latissimus dorsi myocutaneous flaps to cover large soft tissue defects in the lower limbs of children.

Large soft tissue lower leg defects in children, especially those around joints, can cause severe secondary and progressive deformity and can interfere with growth of the affected limb. If function is to be restored and possible amputation prevented, repair procedures are necessary. Eight children with such defects, ranging from six to nine years of age, have been treated successfully, using bilateral latissimus dorsi myocutaneous flaps. All the flaps survived, and both functional recovery and cosmetic improvement of the repaired limbs have been satisfactory. Cross-bridge flaps from the contralateral leg were used in four of the cases because no vessels were available for anastomosis at the recipient site. No significant functional impairments at the donor site have been noted. Operative techniques, indications for the procedure, and related problems are discussed.