Microsurgical reconstruction of the upper extremity : state of the art

TOC.pdf......Page 1
01.pdf......Page 3
02.pdf......Page 6
Preface......Page 7
Range of movement, bone, and tendon......Page 9
Classification......Page 10
Indications for replantation......Page 11
Digit......Page 12
Dorsal repair......Page 13
Distal replants......Page 14
Prolonged ischemia and the ‘‘no reflow’’ phenomenon......Page 15
Survival......Page 16
Function......Page 17
Summary......Page 18
References......Page 19
Initial emergent care......Page 21
Operative techniques......Page 23
Postoperative care......Page 25
Results......Page 27
References......Page 28
Radical versus serial debridement......Page 30
Principles of radical debridement......Page 31
Emergency free flaps......Page 33
History......Page 34
Lateral arm flap......Page 35
Groin flap......Page 37
Immediate reconstruction......Page 38
References......Page 43
Initial requirements......Page 44
Indications for free flaps......Page 45
Selection of free flaps......Page 46
Radial forearm flap......Page 47
Anterolateral thigh flap......Page 48
Osteocutaneous free fibular flap......Page 49
Latissimus dorsi flap......Page 50
Serratus muscle flap......Page 51
Postoperative care......Page 52
References......Page 54
History......Page 56
Specific indications......Page 57
Scapulo-humeral defect......Page 58
Radius/ulna diaphyseal defect......Page 60
Forearm-carpal defect......Page 61
Summary......Page 62
References......Page 63
History of muscle transplantation......Page 64
Indications......Page 65
Functioning free muscle transfer......Page 66
Management of established Volkmann’s ischemic contracture......Page 67
Clinical assessment......Page 68
Functioning free muscle transfer for Volkmann’s ischemic contracture......Page 69
Gracilis muscle preparation......Page 71
Gracilis muscle transfer to the forearm......Page 72
Postoperative care......Page 74
Complications......Page 75
Operative technique of muscle transplantation to the arm for biceps function......Page 76
Results......Page 77
References......Page 79
Anatomic......Page 80
Intraoperative methods of fascicular identification......Page 81
Nerve grafting......Page 82
Nerve transfers......Page 83
Summary......Page 86
References......Page 87
Adult brachial plexus injuries......Page 89
Conventional versus microneurosurgical treatment for complete brachial plexus palsy......Page 90
Restoring shoulder function in incomplete brachial plexus palsy by way of microneurosurgical reconstruction......Page 91
Incomplete brachial plexus palsy in the adult-lower lesion (C8, T1)......Page 92
Babies with complete (global) palsies......Page 93
References......Page 94
Neurotization......Page 96
Extraplexus neurotization......Page 97
Close-target neurotization......Page 100
General principles for neurotization......Page 101
For shoulder function......Page 102
For elbow flexion......Page 103
Functioning free muscle transplantation......Page 104
Gracilis muscle dissection and muscle insertion......Page 105
XI nerve dissection......Page 106
Postoperative management and rehabilitation......Page 107
References......Page 108
History of thumb reconstruction......Page 110
Preoperative evaluation......Page 111
Surgical technique......Page 112
Postoperative management......Page 116
Postoperative monitoring......Page 117
References......Page 119
Initial management of the patient with nonreplantable finger amputation(s)......Page 121
Reconstruction of single finger amputations......Page 122
Reconstruction of multiple finger amputations......Page 123
Reconstruction of metacarpal hands......Page 124
Dissect the toe vascular pedicles in a retrograde fashion......Page 127
Close the donor site primarily and avoid incisions over weight-bearing areas......Page 128
Measures to avoid flexion deformities in transplanted toes......Page 129
References......Page 130
Evolving indications......Page 133
Parental explanation......Page 134
Evaluation of the child......Page 135
Surgical technique......Page 136
Results......Page 138
References......Page 139
16.pdf......Page 141