Lower Limb Trauma
And Reconstruction

About The Treatment

Usually Plastic surgeons are in charge whenever Lower limb trauma is complex as in crush injury or traumatic amputation.  Lower limb reconstruction is to be planned and Plastic surgeons are mainly in charge of the soft tissue defects over the lower extremity.

If Plastic surgeon sees the patient on arrival along with orthopaedic surgeon necessary decision of limb salvage and coverage can be taken at very early stage.

It is not wise to keep an exposed wound open for a long time. Wound must be covered as early as possible. Plastic surgeon can cover by skin grafts or skin flap. Skin flaps can be locoregional  or free flaps,

Sometimes, if the defect is extensive and composite, it might not be possible to do the entire reconstruction in a single surgery. In such cases, multiple procedures are needed to provide an optimal functional and aesthetic outcome to the patient. For example, if the defect consists of bone loss as well as soft tissue loss, a decision might be taken to cover the soft tissue first. The leg is kept in an external fixator during that time, and secondary bony reconstruction is considered after a couple of weeks.

Tendon transfers are surgical procedures where some of the lesser important muscles/tendons are used to replace the function of the more important muscles /tendons.

Another important aspect of lower limb reconstruction is to provide sensory innervations if is lost .This necessitates nerve reconstruction using primary suturing of nerve grafts.

To sum up, lower limb reconstruction is complicated and needs multidisciplinary management for best possible outcomes. Multiple procedures might be needed for optimal functional outcomes. Opinion of the plastic surgeon must be solicited early  to expedite the recovery, and improve the outcomes.