Restoration of upper extremity function poses a unique surgical challenge.With considerations ranging from ensuring appropriate skeletal support and musculotendinous and ligamentous anatomy,restoring adequate vascular...Restoration of upper extremity function poses a unique surgical challenge.With considerations ranging from ensuring appropriate skeletal support and musculotendinous and ligamentous anatomy,restoring adequate vascularity and innervation,and providing sufficient soft tissue coverage,upper extremity injuries present a diverse range of reconstructive problems.Recent history has been marked by an expansion of novel techniques for addressing these complex issues.Sophisticated modalities,such as targeted muscle reinnervation,free functional muscle transfer,and vascularized composite allotransplantation,have become some of the most powerful tools in the armamentarium of the reconstructive surgeon.This review article aims to define the distinguishing features of each of these modalities and reviews some of their unique advantages and limitations.展开更多
The management of extremity soft tissue sarcoma is constantly evolving, and, in recent decades, limb salvage has been the main goal. More commonly, this is being achieved with a combination of neo-adjuvant radiotherap...The management of extremity soft tissue sarcoma is constantly evolving, and, in recent decades, limb salvage has been the main goal. More commonly, this is being achieved with a combination of neo-adjuvant radiotherapy,followed by wide excision and soft tissue reconstruction in the form of vascularised soft tissue transfer. Although limb salvage is now readily achievable, the resultant functional disabilities following excision of major musculotendinous and neurovascular structures can be life changing. In recent years, there has been a move towards functional limb reconstruction in the form of free functioning muscle transfer. This paper reviews the advances in functional limb reconstruction in the setting of preoperative radiation and reports our experience in this challenging reconstructive field.展开更多
文摘Restoration of upper extremity function poses a unique surgical challenge.With considerations ranging from ensuring appropriate skeletal support and musculotendinous and ligamentous anatomy,restoring adequate vascularity and innervation,and providing sufficient soft tissue coverage,upper extremity injuries present a diverse range of reconstructive problems.Recent history has been marked by an expansion of novel techniques for addressing these complex issues.Sophisticated modalities,such as targeted muscle reinnervation,free functional muscle transfer,and vascularized composite allotransplantation,have become some of the most powerful tools in the armamentarium of the reconstructive surgeon.This review article aims to define the distinguishing features of each of these modalities and reviews some of their unique advantages and limitations.
文摘The management of extremity soft tissue sarcoma is constantly evolving, and, in recent decades, limb salvage has been the main goal. More commonly, this is being achieved with a combination of neo-adjuvant radiotherapy,followed by wide excision and soft tissue reconstruction in the form of vascularised soft tissue transfer. Although limb salvage is now readily achievable, the resultant functional disabilities following excision of major musculotendinous and neurovascular structures can be life changing. In recent years, there has been a move towards functional limb reconstruction in the form of free functioning muscle transfer. This paper reviews the advances in functional limb reconstruction in the setting of preoperative radiation and reports our experience in this challenging reconstructive field.
