Functional Limb Salvage

Taking a truly interdisciplinary approach to the topic, Functional Limb Salvage is a ready reference for all clinicians and surgeons treating this patient population, including plastic, vascular, orthopedic and podiatric surgeons and their support staff. The content of this text is focused on defining and expanding upon the importance and, more specifically, the intricacies of the multidisciplinary team approach. Although this is often touched upon or cited as an integral aspect of care, there are only sparse descriptions of the interplay of multiple team members in concert with the care of this challenging patient population. This comprehensive text opens with definitions, demographics, epidemiology, pathophysiology and etiology of the limb salvage patient population, whether due to infection, ischemia or deformity. The multidisciplinary team itself is then outlined, from the who, when and where of the intervention to the role of the individual clinicians themselves; from vascular and plastic surgeons to podiatric and orthopedic surgeons, multiple medical specialties, and with thorough attention to the integral support staff of NPs, PAs and many others. History and assessment are then discussed as a prelude to both conservative and surgical treatments, including wound healing optimization, orthotics and prosthetics, skin grafting, amputation, bioengineered tissue and more. A final chapter on innovation and landmark publications rounds out the presentation.

An international group ofresearchers has met every 2 years since 1981 to examine the progress made in limb salvage techniques and the perspectives of this field of surgery. In 1989 the Fifth International Symposium On Limb Salvage (ISOLS) was held in Saint Malo and was attended by more than 300 participants from 34 different countries. The 105 papers presented, grouped under eleven main headings, have been included in this book. Limb salvage has indeed progressed in the years since the first symposium. Initially it essentially concerned tumours and the main aim was to salvage the diseased limb through non-mutilating surgery without jeopardizing the patient's prospects of survival. Now, with a confirmed high rate of 5-year disease-free survival, new goals can be set: improvement of the functional results and of the survival of our reconstructions. How can this be achieved: - By favouring muscle reattachment on the prosthesis, for instance through the use of a bone allograft-sleeved composite prosthesis? - By improving the survival of the arthroplasty through the develop ment of a more biological fixation of its stems? - By limiting the side effects of the necessary adjuvant treatments on the function of the allograft as well as on the fixation of the prosthesis? In addition, limb salvage procedures now concern not only primary tumours (and metastases, which must be treated using the same osteosynthetic and prosthetic techniques), but also reconstructive orthopaedic surgery as a whole.

This book provides a practical guide to the treatment of patients as risk from limb amputation. The most common presentations of the diabetic foot are presented in concise and evidence-based chapters covering the neuropathic foot, the Charcot foot, the ischemic foot, and the infected foot. Each section includes an introduction to the clinical approach as well as an algorithm illustrating the limb salvage pathway and intervention steps. Limb Salvage of the Diabetic Foot: An Interdisciplinary Approach aims to help the reader build an interdisciplinary understanding of the diabetic foot and its treatment and is of interest to all members of the interdisciplinary diabetic foot team including surgeons, podiatrists, radiologists, nurses, orthotists, infectious disease physicians, and endocrinologists.

An international group ofresearchers has met every 2 years since 1981 to examine the progress made in limb salvage techniques and the perspectives of this field of surgery. In 1989 the Fifth International Symposium On Limb Salvage (ISOLS) was held in Saint Malo and was attended by more than 300 participants from 34 different countries. The 105 papers presented, grouped under eleven main headings, have been included in this book. Limb salvage has indeed progressed in the years since the first symposium. Initially it essentially concerned tumours and the main aim was to salvage the diseased limb through non-mutilating surgery without jeopardizing the patient's prospects of survival. Now, with a confirmed high rate of 5-year disease-free survival, new goals can be set: improvement of the functional results and of the survival of our reconstructions. How can this be achieved: - By favouring muscle reattachment on the prosthesis, for instance through the use of a bone allograft-sleeved composite prosthesis? - By improving the survival of the arthroplasty through the develop ment of a more biological fixation of its stems? - By limiting the side effects of the necessary adjuvant treatments on the function of the allograft as well as on the fixation of the prosthesis? In addition, limb salvage procedures now concern not only primary tumours (and metastases, which must be treated using the same osteosynthetic and prosthetic techniques), but also reconstructive orthopaedic surgery as a whole.

This practical and generously illustrated text presents the current concepts regarding the management of the mangled extremity, including microsurgery, vascular surgery, free tissue, nerve, hand, and replantation surgery. Since the advent of microsurgical reconstruction, significant progress has been made in the areas of replantation, free tissue transfer, as well as the refinement of skeletal fixation techniques. The scope will encompass the initial triage of a patient with a mangled upper or lower extremity, the initial and subsequent reconstructive efforts, to include skeletal fixation, vascular and soft tissue reconstruction, muscle and tendon transfers, psychological impact, therapy requirements, amputation considerations, and current data on salvage versus amputation in these scenarios. Case examples will be included to add further depth and context to the techniques and recommendations provided. Presenting these surgical challenges in detail, The Mangled Extremity will be an ideal resource for orthopedic and trauma surgeons, residents and fellows, as well as emergency surgeons facing these intense, traumatic injuries.