Soft Tissue Coverage of the Hand and Upper Extremity: The Reconstructive Elevator.
Soft tissue reconstruction of the upper extremity is a complex topic because every defect has multiple potential solutions. Whereas the often-cited reconstructive ladder advised selection of the simplest reconstruction of the defect, the newer concept of the reconstructive elevator allows freedom to choose a more complex reconstruction to account for specialized function and aesthetic outcome. An algorithm for assessment of the defect is presented and demonstrated in this review, using 6 case examples to highlight key concepts. Representative flaps are presented and a discussion of functional and aesthetic outcomes is undertaken to provide a framework for achieving the patient's and surgeon's goals of reconstruction.
Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA.
Erin Anne
EA
Miller
Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA. Electronic address: jfriedri@uw.edu.
Jeffrey
J
Friedrich
D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D034941:Upper Extremity / Q000293:injuries / Q000601:surgery*
Hand reconstruction; perforator flap; reconstructive elevator; soft tissue