Achilles tendon and soft-tissue contractures caused by trauma to the foot and ankle are complex injuries. An array of techniques, including local and distant flaps, has been used and described to reconstruct these challenging wounds. However, the management of these injuries in a growing child who develops abnormal gait due to equinus deformity has not been categorically reported. The latissimus dorsi myocutaneous flap has the advantage of a rich blood supply making specific partial muscle harvest possible. In this case series, we report on five paediatric patients with severe contracture of the Achilles tendon and posterior ankle, who were reconstructed with free partial latissimus dorsi myocutaneous flaps. All flaps survived and satisfactory form and function of the ankle joint were achieved with minimal donor morbidity. We believe that the free partial latissimus dorsi myocutaneous flap is an excellent option for the soft-tissue reconstruction of severe Achilles tendon contracture in children.
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