The Mangled Extremity, 1st ed. 2021
Evaluation and Management

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.

The Triage of the Patient with the Mangled Extremity

Temporizing and Definitive Skeletal Fixation for the Mangled Lower Extremity

Temporizing and Definitive Skeletal Fixation for the Mangled Upper Extremity

Revascularization of the Mangled Limb

Replantation of the Mangled Upper Extremity

Non-Microsurgical Soft Tissue Coverage of the Mangled Limb

Microsurgical Reconstruction for the Mangled Limb.- Growing Bone: Lengthening and Grafting

Restoring Function: Tendon and Nerve Transfers

Functional Muscle Transfer for the Mangled Limb

The Psychological Impact of the Mangled Limb

Therapy Requirements and Goals of the Patient with the Mangled Limb

Non-Opioid Strategies for Pain Management

Salvage vs. Amputation: Lower Extremity and Upper Extremity

Orthotic Management of the Mangled Extremity

Prosthetic Care for the Mangled Extremity

The Mangled Extremity: Osseointegration

Raymond Pensy, MD

Associate Professor

Program Director, Hand, Upper Extremity and Microvascular Fellowship

Chief, Hand & Upper Extremity Trauma

R Adams Cowley Shock Trauma Center

Division of Orthopaedic Traumatology

Department of Orthopaedic Surgery

 

John Ingari, MD, FAOA

Associate Professor

Chief, Hand Surgery Division

Program Director, Orthopaedic Surgery

Sinai Hospital of Baltimore