Microsurgical Reconstruction of the Upper Extremity in a Level 1 Trauma Center
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How do you decide whether a severely injured limb can still be salvaged—and what should reconstruction actually aim to restore? This lecture follows challenging upper-extremity trauma cases from a Level 1 trauma center, with an emphasis on microsurgical decision-making and functional outcomes.
The discussion moves beyond the classic reconstructive ladder toward an elevator concept: choosing the option that best serves the patient, even when that means moving directly to free tissue transfer. Cases illustrate vascularized bone reconstruction, flow-through flaps, nerve grafting and nerve transfers, tendon reconstruction, replantation, tension-free flap inset, and strategies for preserving distal arterial inflow.
Along the way, the speaker shares practical lessons on tourniquet safety, debridement, antibiotic spacers, fixation, donor-site morbidity, venous congestion, and rehabilitation—including several unconventional solutions developed when standard implants or techniques were not available.
The discussion moves beyond the classic reconstructive ladder toward an elevator concept: choosing the option that best serves the patient, even when that means moving directly to free tissue transfer. Cases illustrate vascularized bone reconstruction, flow-through flaps, nerve grafting and nerve transfers, tendon reconstruction, replantation, tension-free flap inset, and strategies for preserving distal arterial inflow.
Along the way, the speaker shares practical lessons on tourniquet safety, debridement, antibiotic spacers, fixation, donor-site morbidity, venous congestion, and rehabilitation—including several unconventional solutions developed when standard implants or techniques were not available.
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 Now playing
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
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.
Microsurgical Reconstruction of the Upper Extremity in a Level 1 Trauma Center