Salvage of planned ALT flap with rectus femoris free flap for pediatric lower extremity reconstruction: A demonstrative case report

INTRODUCTION: Free tissue transfer in children represents a good option for reconstruction in skilled hands despite the technical difficulties, and represent a significant challenge in microsurgery. With Anteriorlateral thigh flap is a popular option even in pediatric age group. PRESENTATION OF CASE: We report here a case of 9 year old girl that sustained a lower extremity trauma with exposed ankle joint secondary to Motor Vehicle Crash, That was planned for (ALT) Anterior Lateral Thigh flap reconstruction, and was not completed and salvaged by rectus femoris flap as an alternative option on table to complete the reconstruction. DISCUSSION: Such case was successfully reconstructed by rectus femoris muscle free flap when ALT (Anterior lateral thigh) flap could not be completed as planned although it’s the workhorse flap in majority of cases, due to absence of perforator utilizing the same vascular anatomical blood supply with no significant donor site morbidity. CONCLUSION: Based on this case report the rectus femoris flap was successfully performed, and we believe it’s an effective and reliable backup option to reconstruct complex lower extremity wound even in pediatric age group.