A Review on the Orthoplastic Approach to Lower Limb Reconstruction
Just as in the craft of carpentry, a stable foundation and framework are absolutely essential to the final function of a building, but no more important than the drywall, trim, and paint that make the building functional, durable, and livable. Reconstruction of the lower extremity is similar; the or...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2019-01-01
|
| Series: | Indian Journal of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688095 |
| _version_ | 1828945324468600832 |
|---|---|
| author | Shaun D. Mendenhall Oded Ben-Amotz Rikesh A. Gandhi L. Scott Levin |
| author_facet | Shaun D. Mendenhall Oded Ben-Amotz Rikesh A. Gandhi L. Scott Levin |
| author_sort | Shaun D. Mendenhall |
| collection | DOAJ |
| description | Just as in the craft of carpentry, a stable foundation and framework are absolutely essential to the final function of a building, but no more important than the drywall, trim, and paint that make the building functional, durable, and livable. Reconstruction of the lower extremity is similar; the orthopaedic surgeon must obtain stable fixation of the damaged or diseased bone once a thorough debridement of nonviable bone is performed, while the plastic or orthopaedic soft tissue surgeon must provide vascularized, stable coverage. These two components are complementary and both contribute to the success or failure of functional limb restoration. The stability of bone repair will predict the ultimate functional status, while the vascularized envelope will enhance the biology of bone and soft tissue healing. When both components are properly attended to, the result is often a functional limb with an acceptable appearance. While a single surgeon need not perform both of these tasks (although some may choose to do so), the orthopaedic and plastic surgeon involved in this care must have a clear understanding of each other's role and their importance for a good outcome. This is what we call the orthoplastic approach to reconstructive surgery of the extremities, that is, the application of principles and practice of both specialties applied simultaneously to optimize the outcomes in limb reconstruction. In this review article, we discuss the history of orthoplastic surgery, the key elements of orthoplastic surgery, and thoughts on factors that lead to good outcomes through select cases. |
| first_indexed | 2024-12-14T04:49:25Z |
| format | Article |
| id | doaj.art-9c6eacd0fd7f486380c69d15f6d15ecd |
| institution | Directory Open Access Journal |
| issn | 0970-0358 1998-376X |
| language | English |
| last_indexed | 2024-12-14T04:49:25Z |
| publishDate | 2019-01-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj.art-9c6eacd0fd7f486380c69d15f6d15ecd2022-12-21T23:16:35ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2019-01-01520101702510.1055/s-0039-1688095A Review on the Orthoplastic Approach to Lower Limb ReconstructionShaun D. Mendenhall0Oded Ben-Amotz1Rikesh A. Gandhi2L. Scott Levin3Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United StatesDepartment of Orthopaedic Surgery, Rambam Health Care Campus, Haifa, IsraelDepartment of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United StatesDepartment of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United StatesJust as in the craft of carpentry, a stable foundation and framework are absolutely essential to the final function of a building, but no more important than the drywall, trim, and paint that make the building functional, durable, and livable. Reconstruction of the lower extremity is similar; the orthopaedic surgeon must obtain stable fixation of the damaged or diseased bone once a thorough debridement of nonviable bone is performed, while the plastic or orthopaedic soft tissue surgeon must provide vascularized, stable coverage. These two components are complementary and both contribute to the success or failure of functional limb restoration. The stability of bone repair will predict the ultimate functional status, while the vascularized envelope will enhance the biology of bone and soft tissue healing. When both components are properly attended to, the result is often a functional limb with an acceptable appearance. While a single surgeon need not perform both of these tasks (although some may choose to do so), the orthopaedic and plastic surgeon involved in this care must have a clear understanding of each other's role and their importance for a good outcome. This is what we call the orthoplastic approach to reconstructive surgery of the extremities, that is, the application of principles and practice of both specialties applied simultaneously to optimize the outcomes in limb reconstruction. In this review article, we discuss the history of orthoplastic surgery, the key elements of orthoplastic surgery, and thoughts on factors that lead to good outcomes through select cases.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688095orthoplasticopen fracturelimb salvagesoft tissue coveragereconstructive microsurgerysoft tissue reconstructionbone reconstruction |
| spellingShingle | Shaun D. Mendenhall Oded Ben-Amotz Rikesh A. Gandhi L. Scott Levin A Review on the Orthoplastic Approach to Lower Limb Reconstruction Indian Journal of Plastic Surgery orthoplastic open fracture limb salvage soft tissue coverage reconstructive microsurgery soft tissue reconstruction bone reconstruction |
| title | A Review on the Orthoplastic Approach to Lower Limb Reconstruction |
| title_full | A Review on the Orthoplastic Approach to Lower Limb Reconstruction |
| title_fullStr | A Review on the Orthoplastic Approach to Lower Limb Reconstruction |
| title_full_unstemmed | A Review on the Orthoplastic Approach to Lower Limb Reconstruction |
| title_short | A Review on the Orthoplastic Approach to Lower Limb Reconstruction |
| title_sort | review on the orthoplastic approach to lower limb reconstruction |
| topic | orthoplastic open fracture limb salvage soft tissue coverage reconstructive microsurgery soft tissue reconstruction bone reconstruction |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688095 |
| work_keys_str_mv | AT shaundmendenhall areviewontheorthoplasticapproachtolowerlimbreconstruction AT odedbenamotz areviewontheorthoplasticapproachtolowerlimbreconstruction AT rikeshagandhi areviewontheorthoplasticapproachtolowerlimbreconstruction AT lscottlevin areviewontheorthoplasticapproachtolowerlimbreconstruction AT shaundmendenhall reviewontheorthoplasticapproachtolowerlimbreconstruction AT odedbenamotz reviewontheorthoplasticapproachtolowerlimbreconstruction AT rikeshagandhi reviewontheorthoplasticapproachtolowerlimbreconstruction AT lscottlevin reviewontheorthoplasticapproachtolowerlimbreconstruction |