Reconstruction of Post-Traumatic Tissue Defects of the Upper Extremity
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Severe upper-limb war injuries rarely involve a single structure. Bone loss, soft-tissue defects, nerve damage, joint problems, infection risk, and previous operations often have to be managed as one long reconstructive pathway.
Igor Kurinniy explains how his team approaches these patients step by step: from clinical assessment and purposeful imaging to soft-tissue coverage, skeletal stabilization, nerve reconstruction, tendon procedures, bone grafting, and later corrective surgery. A major focus is not only what operation to perform, but when to perform it — and why moving too quickly between stages can compromise the entire reconstruction.
The lecture is built around complex clinical cases involving the humerus and forearm, large combined skin-and-bone defects, free tissue transfer, shortening strategies, vascularized bone reconstruction, tendon transpositions, and restoration of useful hand function. The discussion also explores practical questions about abdominal flaps, fibular grafts, 3D-printed titanium implants, flap selection in patients with thicker subcutaneous tissue, and the role of multidisciplinary reconstructive teams.
For surgeons learning to manage high-energy trauma, this is a detailed look at the reasoning behind staged reconstruction — where technical skill matters, but sequencing, timing, and preserving future options may matter even more.
Igor Kurinniy explains how his team approaches these patients step by step: from clinical assessment and purposeful imaging to soft-tissue coverage, skeletal stabilization, nerve reconstruction, tendon procedures, bone grafting, and later corrective surgery. A major focus is not only what operation to perform, but when to perform it — and why moving too quickly between stages can compromise the entire reconstruction.
The lecture is built around complex clinical cases involving the humerus and forearm, large combined skin-and-bone defects, free tissue transfer, shortening strategies, vascularized bone reconstruction, tendon transpositions, and restoration of useful hand function. The discussion also explores practical questions about abdominal flaps, fibular grafts, 3D-printed titanium implants, flap selection in patients with thicker subcutaneous tissue, and the role of multidisciplinary reconstructive teams.
For surgeons learning to manage high-energy trauma, this is a detailed look at the reasoning behind staged reconstruction — where technical skill matters, but sequencing, timing, and preserving future options may matter even more.
PRAS-04
Course
Upper Extremity and Hand Reconstruction: From Congenital Anomalies to Complex Trauma
01
45:14 Now playing
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
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.
Reconstruction of Post-Traumatic Tissue Defects of the Upper Extremity