Complex Lower Limb Trauma

Complex Lower Limb Trauma

Plastic surgeon comes in to the picture when the limb is completely amputated, or bone is exposed as in Open grade fracture or when nerve and muscles are damaged. Early intervention by a plastic surgeon within first week of injury gives the best results. Flap coverage to cover the exposed bone and vital structures is most important part of treatment. Obviously reattaching the amputated extremity is most challenging surgery amongst all surgeries.

These surgeries require a great deal of technical skill to repair your bones, tendons, muscles, blood vessels, nerves, and skin. Some patients only need one surgery, but those with more complex concerns may need a staged approach (multiple surgeries).

Lower Extremity Reconstruction Conditions

• Traumatic injuries (such as soft tissue injuries with or without a broken bone or injuries of the muscle, blood vessel, or nerve)
• Non-traumatic injuries (such as open wounds related to diabetes or bone or soft tissue infections)
• Bone and soft tissue reconstruction concerns after tumor/cancer removal
• Post-amputation concerns (such as poor contour, which makes prosthetic fittings difficult, painful nerve stumps, or phantom limb pain)

Lower extremity reconstruction is complex because of the incredible variation of factors involved, including injury location and extensiveness, tissues types involved, and your medical background. Among the most commonly used surgical techniques are fasciocutaneous flaps, muscle flaps, tissue expansion, free tissue transfer, and microsurgery. Surgery can take anywhere from 2 - 6 hours and will be conducted under general anesthesia. For relatively uncomplicated injuries, Dr. Nischal may take a simple closure approach in which he makes an incision in the skin, reconstructs the wound as needed, and closes it with sutures. More complex cases may require the rearrangement of soft tissue to close over open skeletal tissue. In such instances, Dr. Nischal may need to combine several techniques like skin and/or bone grafting, and free tissue transfer using microsurgery.