Orthoplastic surgery for interdisciplinary extremity reconstruction.

Objectives: Combined bone and soft tissue injuries and defects pose a challenge for the interdisciplinary orthoplastic surgical team. These conditions are not only encountered in young, healthy patients, but, due to various causes ranging from trauma over chronic osteomyelitis to tumor resection, also in patients with pre-existing vascular disease and even many years after the initial trauma. Methods: An efficient interdisciplinary treatment approach by orthopedic/trauma surgeons and plastic surgeons, and if necessary, vascular surgeons, who develop a joint strategy as early as possible is crucial for optimal functional restoration of form and function. Results: The goal of this orthoplastic approach is early definitive fracture stabilization or bony reconstruction combined with adequate soft tissue coverage and reconstruction of other injured structures such as vessels, nerves, and tendons, in order to begin rehabilitation as early as possible. Conclusions: The different steps of the orthoplastic surgical approach for interdisciplinary extremity reconstruction is described in the following manuscript and should encourage and provide a guideline for other orthoplastic teams, possibly leading to establishing specialized extremity reconstruction centers.