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Phase IV: Late Reconstruction, Plastic Surgery for Orthopedics

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Damage Control Management in the Polytrauma Patient

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Abstract

In 1919, Sir Harold Gillies wrote a pioneering textbook that has proven pivotal in the modern development of plastic surgery. The preface to his text was written by Sir W. Arbuthnot Lane, an orthopedic surgeon, thus beginning the publicized modern era of “orthoplastic surgery” [27]. Orthoplastic surgery is not just a term that should be casually used anytime a plastic and orthopedic surgeon work on the same patient for it does not define the true collaboration between orthopedic and plastic surgeons who are capable of seeing that bone, muscle, tendon, and skin are best treated compositely. One team does not fix the bone and the other “cover” it. Orthoplastic surgery incorporates early involvement of both orthopedics and plastic surgery with plans developed and followed by the team for the ideal treatment of the limb. Timing of fracture fixation and soft tissue coverage are optimized for the betterment of the composite limb and not for the schedule of the individual teams. When the focus is diverted erroneously to one tissue, frequently the result can be a perfused, possibly united, and covered but poorly functioning limb. When this team functions properly, a synergistic effect occurs, and all parties, most importantly, the patient, benefit.

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Author information

Authors and Affiliations

  1. Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA

    LCDR Scott M. Tintle MD, MC USN

  2. University of Pennsylvania, Philadelphia, PA, 19104, USA

    L. Scott Levin MD

Authors
  1. LCDR Scott M. Tintle MD, MC USN
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  2. L. Scott Levin MD
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Corresponding author

Correspondence to LCDR Scott M. Tintle MD, MC USN .

Editor information

Editors and Affiliations

  1. Department of Trauma, Zurich University, Zurich, Switzerland

    Hans-Christoph Pape

  2. Division of General Surgery, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA

    Andrew B. Peitzman

  3. Department of Surgery, Division of Acute Care Surgery, University of Rochester, Medical Center, Rochester, New York, USA

    Michael F. Rotondo

  4. Department of Academic Trauma & Orthopaedics, University of Leeds, Leeds, West Yorkshire, United Kingdom

    Peter V. Giannoudis

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Tintle, L.S.M., Levin, L.S. (2017). Phase IV: Late Reconstruction, Plastic Surgery for Orthopedics. In: Pape, HC., Peitzman, A., Rotondo, M., Giannoudis, P. (eds) Damage Control Management in the Polytrauma Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-52429-0_19

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  • DOI: https://doi.org/10.1007/978-3-319-52429-0_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52427-6

  • Online ISBN: 978-3-319-52429-0

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