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Approach to Complex Lower Extremity Reconstruction.
Approach to Complex Lower Extremity Reconstruction. Seminars in plastic surgery Cholok, D., Saberski, E., Lowenberg, D. W. 2022; 36 (4): 233-242Abstract
Composite injuries to the lower extremity from etiologies including trauma and infection present a complex dilemma for the reconstructive surgeon, and require multidisciplinary collaboration amongst plastic, vascular, and orthopaedic surgical specialties. Here we present our algorithm for lower-extremity reconstructive management, refined over the last decades to provide an optimized outcome for our patients. Reconstruction is predicated on the establishment of a clean and living wound, where quality of the wound-bed is prioritized over timing to soft-tissue coverage. Once established, soft-tissues and fractures are provisionally stabilized; our preference for definitive coverage is for microvascular free-tissue, due to the paucity of healthy soft-tissue available at the injury, and ability to avoid the zone of injury for microvascular anastomosis. Finally, definitive bony reconstruction is dictated by the length and location of long-bone defect, with a preference to utilize bone transport for defects longer than 5?cm.
View details for DOI 10.1055/s-0042-1758205
View details for PubMedID 36561427
View details for PubMedCentralID PMC9762997