In a fraction of a second a sunny afternoon turned to gray as this 4 year olds foot slipped under the lawn mower. The blades severed the Achilles tendon, fractured the heel bones and removed a large segment of skin. After several trips to the operating room to decontaminate this complex wound, local tissues from the back of the calf were turned down to reconstruct the heel (reverse sural neurofasciocutaneous flap). With intravenous antibiotics, support and rehabilitation this child healed and resumed his normal activities and is an active member of his little league baseball team.

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