Reconstruction arms & legs

The main objectives of these reconstructive measures are

• the restoration of function
• to improve the aesthetic appearance
• to improve the patient's general quality of life

In this area of plastic surgery, various highly developed techniques are used, each tailored to the specific needs of the patient and the complexity of the defect.

Traumatic injuries
Traumatic injuries such as fractures, deep cuts and avulsions can lead to significant soft tissue loss or damage to the limbs.

Reconstructive strategies often include wound care, skin grafts and flap surgery to cover exposed tissue and promote healing.

In severe injuries, microsurgical techniques may be used to cover or reconstruct different types of tissue, requiring precise connection of blood vessels and nerves to restore function and sensation.

Burns
Burn injuries can lead to extensive skin and tissue damage, resulting in scarring, contractures and restricted movement.

Reconstructive surgery for burn victims usually involves the resolution of contractures through local plasty or the use of skin grafts and local or free flaps to replace the damaged skin and improve functional outcomes.

Cancer resections
Limb-preserving surgery for bone and soft tissue sarcomas often requires extensive reconstruction to fill the defects created by tumour removal. This may include bone grafts or arthroplasty replacements for skeletal defects and soft tissue flaps to cover and reconstruct the affected areas.

The aim is to preserve or restore as much function as possible while achieving a cosmetically acceptable result.

Skin transplants: Skin is transferred from one part of the body to another to cover defects. The grafts can be divided (with only a few layers of skin) or full-thickness (with the entire depth of the skin).

Flap grafting: This technique involves the transfer of living tissue, including skin, fat, muscle and sometimes bone, from one area of the body to another. Flaps can be pedicled (retaining their original blood supply) or free (reconnected to the blood vessels at the new site using microsurgery).

Microsurgery: Microsurgical techniques are often used in limb reconstruction for the reattachment of severed parts or free flap transfers. These complicated procedures involve suturing tiny blood vessels and nerves under a microscope to restore blood flow and sensation.

Prosthetics and orthotics: In cases where reconstruction cannot fully restore function, prosthetics or orthotics can be used to improve mobility and the ability to perform daily activities.

The challenges of limb reconstruction require not only surgical expertise, but also a deep understanding of limb biomechanics and a commitment to individualised patient care.

Limb reconstruction is therefore an interdisciplinary field in which plastic surgeons, orthopaedic surgeons, physiotherapists, occupational therapists and orthopaedic technicians work together.

Post-operative rehabilitation is crucial to maximise functional recovery and integrate the reconstructed limb into the patient's daily life.

With constant advances in surgical techniques, materials and prosthetic technology, the potential for functional and aesthetic restoration is growing, offering hope and better outcomes for patients with limb defects.