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Degloving injuries and high-energy trauma of distal lower extremity is fortunately rare in children and there are a limited number of articles that have been written about microsurgical management of these injuries. In the pediatric population, it was realized that free flaps could be safely used in the treatment of soft-tissue defects. First, critical issues as to the feasibility and reliability of the intervention in children were rapidly overcome as it was realized that the relative size of the pedicle vessels is larger in children than that in adults. The same holds true for the perforator vessels; although they can be relatively small in children, their relative size compared with the size of the child’s body is greater than that in adults. In this case report, a 7 year-old boy sustained a severe mangling, crushing type injury of his right ankle in an elevator-door related accident. He sustained a degloving injury of the anterolateral aspect of the ankle, an ipsilateral tarsal fracture and ankle subluxation. We have confirmed the versatility and safety of the medial circumflex femoral artery perforator flap in this type of injury within the first 24-hours after the injury. Without undermining, the donor site was closed directly in an almost linear scaring the gluteal fold that can be easily concealed. We found the medial circumflex femoral artery perforator flap is one of safe and suitable flap choice in children who have a defect on the distal one third of tibia in the acute period of trauma.

Medial Circumflex Femoral Artery Perforator Flap in a Seven-Year-Old Boy for a Degloving Ankle Injury: A case report in immediate reconstruction