1 What is a severe defect? 3
2 Pedicled fasciocutaneous and adipofascial flaps 7
3 Pedicled muscle and musculocutaneous flaps 23
4 Free flaps 33
5 Emergency free flaps for the reconstruction of open injuries of the upper limb 51
6 Bone auto-and allografts in post-traumatic reconstruction of the upper limb 59
7 Massive bone defects of the upper limb: reconstruction by vascularized bone transfer 75
8 Loss of the post-traumatic infected substance of the upper limb 87
9 Bone substitutes 99
10 Joint transfers and joint reconstruction 109
11 Joint replacement as a secondary procedure 117
12 Joint fusion in severe traumatic defects of the upper limb 125
13 Nerve grafts 137
14 Bridging nerve defects: the role of tissue interpositioning 153
15 End-to-side neurorrhaphy: an alternative method for reinnervation in cases with long nerve defects 169
16 Conventional tendon grafting 183
17 When to use vascularized tendon transfers and how is the digital flexion sliding system supposed to work? 227
18 Composite tissue transfer in the upper extremity 241
19 Free functioning muscle transfer 251
20 Combined soft tissue and tendon reconstruction: the dorsum and thenar regions 261
21 Principles of emergency reconstruction 277
22 Principles or repair of a compound defect as a secondary procedure: the multiple stages approach 287
23 Surgical management of infection 295
24 Reconstruction of large defects of the upper limb in children 303
25 Future advances in hand and upper limb surgery: application of tissue engineering and biotechnology 313
Index 323
"After injury the upper limb can often be left with severe mutilation with devastating consequences for
the patient s daily life. This book assembles international experts to present the latest clinical
thinking on the correct strategy to adopt in surgical management. Flaps bone and joint reconstruction
nerve and tendon defect repair and compound transfers are all included (although finger mutilation is
not)."