Lower Extremity Reconstruction: A Practical Guide

Lower Extremity Reconstruction: A Practical Guide
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Title Page
Copyright
Contents
Videos
Foreword
Preface
Preface
Acknowledgment
Acknowledgments
Contributors
1. Our Introduction to Lower Extremity Reconstruction
	1.1 Introduction
	1.2 History
	1.3 Basic Principles
	1.4 Conclusion
2. Assessment of the Normal and Impaired Lower Extremity
	2.1 Introduction
	2.2 Assessment of the Normal Lower Extremity
	2.3 Assessment of the Impaired Lower Extremity
	2.4 Compartment Syndrome
	2.5 Degloving Injuries
	2.6 Crush Syndrome
	2.7 Osteomyelitis
	2.8 Diabetic Foot
	2.9 Conclusion
3. Indications for Vascular Intervention in Lower Extremity Reconstruction
	3.1 Introduction
	3.2 Principles of Limb Salvage
	3.3 Anatomy
	3.4 Vascular Evaluation
	3.5 Plastic Surgery Indications for Vascular Surgical Intervention
	3.6 Special Considerations for the \"Vascular/Diabetic\" Patient
4. Orthopaedic Evaluation of the Lower Extremity and the Concept of the Orthoplastic Approach
	4.1 Introduction
	4.2 The Orthoplastic Approach
	4.3 Orthopaedic Evaluation of the Injured Extremity
	4.4 The Role and Timing of Debridement
	4.5 Basic Principles of Bone Fixation
	4.6 Limb Salvage versus Amputation
	4.7 Other Applications of Orthoplastic Surgery
	4.8 Conclusion
5. Surgical Approach to Pediatric Bone and Soft-Tissue Tumors of the Lower Extremity
	5.1 Introduction
	5.2 Types of Sarcoma
	5.3 Staging
	5.4 Diagnosis
	5.5 Surgical Management
	5.6 Conclusion
6. Spare-Part Surgery
	6.1 Introduction
	6.2 Debridement
	6.3 Extracorporeal Membrane Oxygenation Circuit
	6.4 Tissue Graft
	6.5 Fillet Flaps
	6.6 Postoperative Care
	6.7 Complications
7. Using the Flap and Angiosome Concepts to Optimize Functional Lower Leg and Foot Amputations
	7.1 Introduction
	7.2 Conclusion
8. Vascular Anatomy of the Lower Extremity: A Practical Guide to Vascular Territories, Perforators, and Selection of Recipient Vessels
	8.1 Introduction
	8.2 Vascular Territories and the Angiosome Concept
	8.3 Arterial Territories
	8.4 Venous Drainage
	8.5 Neurovascular Territories
	8.6 Vascular Anatomical Principles Applied to Flap Design
	8.7 Main Source Vessels of the Lower Extremity
	8.8 Regional Anatomy of Perforators of the Lower Extremity
	8.9 Anatomical Regions
	8.10 Selection of Recipient Vessels
9. Importance of Vascularity and Selecting the Recipient Vessels in Lower Extremity Reconstruction
	9.1 Introduction
	9.2 Factors to Consider
	9.3 Algorithm for Selecting Recipient Vessel
	9.4 Conclusion
10. General Wound Preparation and Timing
	10.1 Introduction
	10.2 Patient Optimization
	10.3 Timing of Lower Extremity Coverage after Trauma
	10.4 Wound Bed Preparation
	10.5 Conclusion
11. The Pertinence of the Reconstructive Ladder and the Reconstructive Elevator
	11.1 Introduction
	11.2 From Wound Closure to Reconstruction
	11.3 The Modern Era of Lower Extremity Reconstruction
	11.4 The Reconstructive Elevator and the Lower Extremity
	11.5 Conclusion
12. Nonflap Wound Closure Alternatives: Skin Graft, Skin Substitute, Skin Stretch, and Negative-Pressure Wound Therapy
	12.1 Introduction
	12.2 Negative-Pressure Wound Therapy
	12.3 Split-Thickness Skin Graft
	12.4 Skin Substitute for Additional Thickness
	12.5 Serial Closure of the Wound
	12.6 Skin Graft for a Chronic Ulcer
	12.7 Conclusion
13. The Process for Flap Selection by Region of the Lower Extremity
	13.1 Introduction
	13.2 Selection According to the Recipient Site
	13.3 Selection According to the Donor Site
14. The Basic Practical Lower Limb Muscle Local Flaps
	14.1 Introduction
	14.2 Chapter 14A: The Medial and Lateral Gastrocnemius Muscle Flaps
	14.3 Chapter 14B: The Gracilis Local Muscle Flap
	14.4 Chapter 14C: The Soleus Muscle Flap
	14.5 Chapter 14D: The Vastus Lateralis Muscle Flap
15. Basic Local Perforator Flaps of the Lower Extremity
	15.1 Introduction
	15.2 Chapter 15A: The Island Perforator Flap
	15.3 Chapter 15B: Perforator Advancement Flaps Including the Keystone Flap
	15.4 Chapter 15C: The Peninsular Perforator Flap
	15.5 Chapter 15D: The Perforator Propeller Flap
	15.6 Chapter 15E: Medialis Pedis and Other Plantar Flaps
	15.7 Chapter 15F: The Distally Based Sural Flap
16. Common Versatile Free Flaps for the Lower Extremity
	16.1 Introduction
	16.2 Chapter 16A: The Anterolateral Thigh Flap for Lower Extremity
	16.3 Chapter 16B: The Gracilis Muscle Free Flap
	16.4 Chapter 16C: The Versatile Latissimus Dorsi Muscle Free Flap
	16.5 Chapter 16D: The Medial Sural Artery Perforator Flap
	16.6 Chapter 16E: The Thoracodorsal Artery Perforator Free Flap
17. Supermicrosurgery Approach to the Lower Limb
	17.1 Introduction
	17.2 Attributes and Detriments
	17.3 Anatomical Consideration
	17.4 Anatomical Variants and Pitfalls
	17.5 Surgical Approach
	17.6 Postoperative Care Protocol
	17.7 Conclusion
18. Diabetic Foot Reconstruction
	18.1 Introduction
	18.2 Attributes and Detriments
	18.3 Considerations
	18.4 Surgical Algorithm
	18.5 Soft-Tissue Reconstruction
	18.6 Postoperative Care
	18.7 Conclusion
19. Rationale for Lower Limb Sensate Flaps
	19.1 Introduction
	19.2 Attributes and Detriments
	19.3 Anatomical Considerations
	19.4 Anatomical Variants and Potential Pitfalls
	19.5 Flap Design and Harvest
	19.6 Postoperative Care Protocols
	19.7 Conclusion
20. A New Concept in Drop Foot Treatment: Ninković\'s Technique-the Neuromusculotendinous Gastrocnemius Transfer
	20.1 Introduction
	20.2 Indications
	20.3 Operative Technique
	20.4 Postoperative Considerations
	20.5 Complications
	20.6 Outcomes
	20.7 Conclusion
21. Modern Concepts of Prosthetic Rehabilitation in Amputation of the Lower Extremity
	21.1 Introduction to Targeted Muscle and Sensory Reinnervation
	21.2 Introduction to Osseointegration at Below- and Above-Knee Level of Amputation
	21.3 Introduction to Femoral Shortening Osteotomy in Through-Knee Amputees
22. Procurement of Thin Flaps as Indicated in the Lower Extremity
	22.1 Introduction
	22.2 Anatomical Considerations
	22.3 Anatomical Variants and Potential Pitfalls
	22.4 Flap Design
	22.5 Flap Harvest
	22.6 Postoperative Care Protocols
	22.7 Conclusion
23. Bone Flaps and Bone Transport for Lower Limb Reconstruction
	23.1 Introduction
	23.2 General Principles for Reconstruction of Bone Defects
	23.3 Fibula Flap
	23.4 Vascularized Rib
	23.5 Medial Femoral Condyle Flap
	23.6 Bone Transport and Distraction Osteogenesis
	23.7 Summary
24. Surgical Treatment for Lower Extremity Lymphedema
	24.1 Introduction
	24.2 Definition of Lymphedema
	24.3 Classification
	24.4 Stage of Lymphedema
	24.5 Symptoms and Complications
	24.6 Diagnosis
	24.7 Treatments
25. Lower Limb Vascularized Composite Allotransplantation
	25.1 Introduction
	25.2 Clinical Example of Lower Limb Vascularized Composite Allotransplantation
	25.3 Discussion
	25.4 Conclusion
26. Perioperative Care and Rehabilitation Specific to the Lower Limb
	26.1 Introduction
	26.2 Perioperative Optimization
	26.3 Immediate Postoperative Management
	26.4 Rehabilitation
Index
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