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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.
List of contents
Rebuilding the Mangled Extremity: Foundation to Rooftop.- The Triage of the Patient with the Mangled Extremity.- Temporizing and Definitive Skeletal Fixation for the Mangled Lower Extremity.- Temporizing and Definitive Skeletal Fixation for the Mangled Upper Extremity.- Revascularization of the Mangled Limb.- Replantation of the Mangled Upper Extremity.- Non-Microsurgical Soft Tissue Coverage of the Mangled Limb.- Microsurgical Reconstruction for the Mangled Limb.- Growing Bone: Lengthening and Grafting.- Restoring Function: Tendon and Nerve Transfers.- Functional Muscle Transfer for the Mangled Limb.- The Psychological Impact of the Mangled Limb.- Therapy Requirements and Goals of the Patient with the Mangled Limb.- Non-Opioid Strategies for Pain Management.- Salvage vs. Amputation: Lower Extremity and Upper Extremity.- Orthotic Management of the Mangled Extremity.- Prosthetic Care for the Mangled Extremity.- The Mangled Extremity: Osseointegration.
About the author
Raymond Pensy, MD
Associate Professor
Program Director, Hand, Upper Extremity and Microvascular Fellowship
Chief, Hand & Upper Extremity Trauma
R Adams Cowley Shock Trauma Center
Division of Orthopaedic Traumatology
Department of Orthopaedic Surgery
John Ingari, MD, FAOA
Associate Professor
Chief, Hand Surgery Division
Program Director, Orthopaedic Surgery
Sinai Hospital of Baltimore
Summary
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.
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