I investigated the long-term results over a 20-year follow-up period after free scapular flap transfer for pediatric dorsal foot run-over injuries. The study included four cases: three male and one female, with ages at injury ranging from 3 years and 3 months to 7 years and 7 months. Hypoplasia, pes cavus deformity, and toe movement disorders were observed on the affected side. Radiographic examination revealed ankle joint osteoarthritis, metatarsal bone defects, and growth disorders. As children grow, they tend to adapt to foot deformities resulting from severe trauma, and their limited toe movement and deformities did not interfere with activities such as walking. The ankle joint is susceptible to developing osteoarthritis due to daily weight-bearing loads, which can cause pain. No functional impairment or significant cosmetic concern was observed at the donor-site shoulder joint.
