Advances made in microsurgical techniques during the last three decades have dramatically improved the treatment of complex limb injuries, such as a closed fracture covered by healthy tissue and a complex open fracture of the tibia. Microvascular transfers from the foot have revolutionized the treatment of digital amputations, and vascularized bone transfers are used in various indications.The microvascular techniques are still evolving. Many imaginative new flaps are being proposed to meet precisely the functional requirements of the various defects. Alternative anastomotic techniques are being investigated and the no-flow phenomenon has been extensively studied. Allotransplantation may be feasible in the future.This unique book is a result of the exchange of ideas among clinicians of various specialties noted for their innovations and basic researchers involved with the problems of microvascular reconstruction of upper and lower extremities. While most of the chapters are invited contributions, some are based on presentations made during an international symposium held in Brussels, Belgium, in 1997.

Advances made in microsurgical techniques during the last three decades have dramatically improved the treatment of complex limb injuries, such as a closed fracture covered by healthy tissue and a complex open fracture of the tibia. Microvascular transfers from the foot have revolutionized the treatment of digital amputations, and vascularized bone transfers are used in various indications.The microvascular techniques are still evolving. Many imaginative new flaps are being proposed to meet precisely the functional requirements of the various defects. Alternative anastomotic techniques are being investigated and the no-flow phenomenon has been extensively studied. Allotransplantation may be feasible in the future.This unique book is a result of the exchange of ideas among clinicians of various specialties noted for their innovations and basic researchers involved with the problems of microvascular reconstruction of upper and lower extremities. While most of the chapters are invited contributions, some are based on presentations made during an international symposium held in Brussels, Belgium, in 1997.

The state-of-the-art guide to lower extremity reconstruction from international experts "I loved witnessing two generations of surgeons working together to capture it all: origin, evolution and progress, state of the art, and the future in one beautifully-crafted and exciting book. This is no doubt a must-read and must-have book." – from the Foreword by Fu-Chan Wei, MD Adequate evaluation of lower limb wounds for salvage requires an itemized assessment of vascular, osseous, soft tissue, and functional deficits. Lower Extremity Reconstruction: A Practical Guide by renowned reconstructive surgeons and perforator flap masters J.P. Hong and Geoffrey G. Hallock presents an orthoplastic approach to this growing and challenging area of microsurgery. Throughout the well-illustrated text and videos, an impressive cadre of international surgeons share pearls and insights, including esoteric knowledge and step-by-step demonstration of techniques with pertinent case examples. This unique guide presents a practical, visual, and stepwise approach to learning and mastering a full array of flap and microsurgery approaches for traumatic, dysvascular, metabolic, and oncologic lower limb defects. Organized into 26 topic-specific chapters, the book covers a full spectrum of lower extremity topics—from wound prep, timing, closure alternatives, and therapy, to soft-tissue tumors and a new concept in drop foot treatment. Numerous videos demonstrate how surgeons can leverage workhorse options to prevent chronic non-healing wounds or amputations and achieve the goal of limb salvage. Key Highlights Lower extremity soft-tissue reconstruction techniques using local muscle and perforator workhorse flaps Bone salvage and restoration techniques, including vascularized bone grafts Diabetic foot management with in-depth discussion of the SCIP flap and perforator-to-perforator concept Rationale for partial and subtotal foot amputation 27 videos and more than 600 illustrations enhance understanding of microsurgical interventions With insights from top microsurgeons on how to achieve the best outcomes for patients with lower limb defects, this is a must-have resource for plastic and orthopaedic surgeons, especially specialists who treat patients at trauma centers.

Reconstructive microvascular surgery is now in its teens. At first many thought this new child was a whim and would fail to thrive. Some were un certain, others with vision either supported or became actively involved in this new area of surgical endeavour. Although initial interest was focused on the replantation of amputated parts, it has been the one stage free trans fer of living tissue to a distant site which has launched microsurgery into the surgical spotlight. From its humble beginnings we have witnessed a revolution in this branch of plastic surgery; many of the long established methods of recon struction have, like barricades, fallen before the advances made in this field. In its infancy there were relatively few procedures available. There was a tendency to make the patient's problem fit the operation, rather than the reverse, and this frequently led to an inferior result. The then known flaps, such as the groin flap and the deltopectoral flap, were employed. Unfortunately they were sites which posed many technical problems; namely those of vascular anomaly, a short pedicle and vessels of small cal ibre. Long operations were the norm, and vascular thrombosis was not un common. Hospital routine often was disrupted and there was a danger that these new techniques would fall into disrepute. Over the last decade this state of affairs has changed dramatically.

This focused, concise book offers an in-depth analysis of lower extremity reconstruction alongside region-specific photos and illustrations. As an anatomical atlas, it seeks to aid the visual learner in showcasing the key steps in setting up and raising the flap for a given defect. Organized into two sections, opening chapters are arranged by general location, focusing specifically on the lower limb. Each general location of a wound is accompanied by an examination of relevant anatomy, including blood supply, nerve supply, arc of rotation of the tissue, and local flap options. Following a description of the anatomy, subsequent paragraphs explain the application of relevant local flap options. Section two incorporates flap demonstration and application into each chapter, offering a more detailed description, true and specific to each anatomical site of the technique. Supplemented by high-quality images and figures, Handbook of Lower Extremity Reconstruction: Clinical Case-Based Review and Flap Atlas is an invaluable reference for practicing plastic and orthopedic surgeons and residents in training.

This practical and generously illustrated text presents the current concepts regarding the management of the mangled extremity, including microsurgery, vascular surgery, free tissue, nerve, hand, and replantation surgery. Since the advent of microsurgical reconstruction, significant progress has been made in the areas of replantation, free tissue transfer, as well as the refinement of skeletal fixation techniques. The scope will encompass the initial triage of a patient with a mangled upper or lower extremity, the initial and subsequent reconstructive efforts, to include skeletal fixation, vascular and soft tissue reconstruction, muscle and tendon transfers, psychological impact, therapy requirements, amputation considerations, and current data on salvage versus amputation in these scenarios. Case examples will be included to add further depth and context to the techniques and recommendations provided. Presenting these surgical challenges in detail, The Mangled Extremity will be an ideal resource for orthopedic and trauma surgeons, residents and fellows, as well as emergency surgeons facing these intense, traumatic injuries.