Management of Gunshot Injuries to Peripheral Nerves
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Gunshot peripheral nerve injuries rarely exist in isolation. In this lecture, reconstructive microsurgeon Andrii Vysak explains how polystructural limb trauma, tissue loss, infection, ischemia, and compartment syndrome shape every reconstructive decision.
Drawing on experience from more than 2,300 patients with gunshot limb injuries, the session follows the pathway from debridement and fasciotomy to soft-tissue coverage, definitive bone fixation, and nerve reconstruction. Particular attention is given to ultrasound and needle EMG, the practical three-week-to-three-month window for reconstruction, neurolysis, nerve repair, autologous nerve grafting, distal nerve transfers, and tendon transfers—along with situations where the standard algorithm does not apply.
Clinical cases and discussion highlight difficult questions: why an anatomically intact nerve may still fail to recover, when VAC therapy becomes a liability, how the mesoneurium and lipofilling affect nerve gliding, and what rehabilitation can realistically change. A clinically dense session for surgeons who want to connect diagnostics, timing, and reconstructive strategy rather than treat the nerve as an isolated structure.
Drawing on experience from more than 2,300 patients with gunshot limb injuries, the session follows the pathway from debridement and fasciotomy to soft-tissue coverage, definitive bone fixation, and nerve reconstruction. Particular attention is given to ultrasound and needle EMG, the practical three-week-to-three-month window for reconstruction, neurolysis, nerve repair, autologous nerve grafting, distal nerve transfers, and tendon transfers—along with situations where the standard algorithm does not apply.
Clinical cases and discussion highlight difficult questions: why an anatomically intact nerve may still fail to recover, when VAC therapy becomes a liability, how the mesoneurium and lipofilling affect nerve gliding, and what rehabilitation can realistically change. A clinically dense session for surgeons who want to connect diagnostics, timing, and reconstructive strategy rather than treat the nerve as an isolated structure.
PRAS-04
Course
Upper Extremity and Hand Reconstruction: From Congenital Anomalies to Complex Trauma
01
45:14
Reconstruction of Post-Traumatic Tissue Defects of the Upper ExtremityA practical lecture on staged reconstruction after severe upper-limb war trauma: soft-tissue coverage, bone defects, nerve repair, fixation timing, microsurgery, and case-based decision-making.
02
54:36
Basic Principles of Surgical Treatment and Postoperative Management of SyndactylyA practical overview of syndactyly surgery, from timing and incision design to full-thickness skin grafting and the often underestimated challenge of postoperative immobilization in young children.
03
1:02:11
Surgical Restoration of Thumb OppositionA focused lecture on restoring thumb opposition after nerve injury and complex hand trauma, with a practical comparison of tendon and muscle transfer techniques.
04
1:03:36
Replantation Surgery: Experience, Decision-Making and Practical AlgorithmsA practical look at replantation surgery built around real clinical cases, from patient selection and correct transport of amputated segments to microsurgical reconstruction, salvage strategies and staged rehabilitation.
05
1:42:12
Microsurgical Reconstruction of the Upper Extremity in a Level 1 Trauma CenterA practical look at complex upper-extremity trauma reconstruction, from aggressive debridement and limb-salvage decisions to free flaps, nerve grafts, flow-through flaps and functional rehabilitation.
06
1:40:27
The Role of Hand Therapy in Restoring Upper Limb Function After Trauma and SurgeryA practical introduction to hand therapy and the often underestimated role of edema management in protecting motion, preventing stiffness, and improving recovery after hand trauma and surgery.
07
1:05:39
Spaghetti Wrist Injury: Repair Strategy, Microsurgery and RehabilitationA practical lecture on complex volar forearm injuries involving multiple tendons, nerves and arteries—from injury mechanism and operative sequencing to microsurgical repair, immobilization and long-term hand rehabilitation.
08
1:31:56
Toe Transfer for Thumb and Finger ReconstructionAn advanced lecture by Prof. Fu-Chan Wei on toe-to-thumb and toe-to-finger transfer in complex hand reconstruction, including indications, surgical planning, technique selection, functional outcomes, donor-site considerations, and rehabilitation.
09
1:32:17 Now playing
Management of Gunshot Injuries to Peripheral NervesAn evidence-informed lecture on diagnosing and reconstructing gunshot peripheral nerve injuries in polystructural limb trauma. Andrii Vysak combines a treatment algorithm, clinical cases, and practical decisions on timing, ultrasound, EMG, nerve grafting, and tendon transfers.
Management of Gunshot Injuries to Peripheral Nerves