title: [Timing of soft tissue reconstruction in severe crush injury of the upper extremity].
abstract: Complex injuries of the distal forearm and the hand by industrial machines often require extensive reconstructive procedures. Crush injuries with soft tissue damage extending over the limits of visible injury require a special approach. Large soft tissue defects often have to be covered by extensive flap procedures. The optimum point of time for plastic reconstruction is an essential question and represents a controversial issue in the literature. To be able to compare different patient cohorts in the future, we classify crush injuries into five clinically relevant categories. In the course of this review article, three different cases of severe crush injuries of the upper extremity are representatively discussed. Two patients were reconstructed in a secondary procedure, one patient in the acute phase. Definite coverage of soft tissue defects in severe crush injuries should be performed secondarily after 5-7 days since the extent of damage in this special form of trauma can often only be judged after a few days and the reconstruction of bones, vessels and tendons is completed.
authors.affiliation: Handchirurgie und Plastische Chirurgie, Kliniken Dr. Erler, Nürnberg. baer.wolfgang@t-online.de
authors.forename: W
authors.initials: W
authors.lastname: Baer
authors.forename: J
authors.initials: J
authors.lastname: Grünert
authors.forename: K
authors.initials: K
authors.lastname: Lerch
authors.forename: S
authors.initials: S
authors.lastname: Ruf
authors.forename: P
authors.initials: P
authors.lastname: Schaller
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D000673:Amputation, Traumatic / Q000000981:diagnostic imaging / Q000601:surgery; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D005543:Forearm Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013524:Surgical Flaps; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery
vernacular_title: Zeitpunkt der Weichteilrekonstruktion bei schweren Quetschtraumen im Bereich der oberen Extremität.