Plastic and Reconstructive Surgery and Orthopaedics Interdisciplinary Cooperation in the Management of Extremity Injuries. Review

Authors: A. Nejedlý 1;  V. Džupa 2;  M. Tvrdek 1
Authors‘ workplace: Klinika plastické chirurgie 3. LF UK a FN Královské Vinohrady, Praha, přednosta: doc. MUDr. M. Tvrdek ;  Ortopedicko-traumatologická klinika 3. LF UK a FN Královské Vinohrady, Praha přednosta: prof. MUDr. J. Bartoníček, DrSc. 2
Published in: Rozhl. Chir., 2008, roč. 87, č. 6, s. 322-327.
Category: Comprehensive Report


Gradual particularization of medicine, as witnessed during the second half of the 20th century, resulted in a detailed development of individual subspecializations. Association of therapeutic options resulting from enormous development of these subspecialization brought a new dimension to the treatment of formerly unmanageable conditions. The closest cooperation between a plastic surgeon and a traumatologist is required in the management of patients with serious extremitiy injuries. The conditions include, in particular, amputations of extremities without skeletal and soft tissue devastation, where replantation may be considered, and extensive soft tissue and skeletal injuries, requiring replacement of the missing soft tissue cover following the treatment of the skeletal parts. A new aspect of the cooperation includes common care for infected long bone fractures and osteomyelitides, where primary and extensive skeletal and soft tissue debridement is followed by covering the defect with a muscular or a musculocutaneous flap, facilitating reperfusion and infection management.

Key words:
interdisciplinary cooperation – replantation of extremities – soft tissue defects – osteomyelitis


1. Bihariesingh, V. J., Stolarczyk, E. M., Karim, R. B., van Kooten, E. O. Plastic solutions for orthopaedic problems. Arch. Orthop. Trauma Surg., 2004, 124, 73–76.

2. Duman, H., Sengezer, M., Celikoz, B., Turegun, M., Isik, S. Lower extremity salvage using a free flap associated with the Ilizarov method in patients with massive combat injuries. Ann. Plast. Surg., 2001, 46, 108–112.

3. Heller, L., Levin, L. S. Lower extremity microsurgical reconstruction. Plast. Reconstr. Surg., 2001, 108, 1029–1041.

4. Komatsu, S., Tamai, S. Successful replantation of a kompletly cut-of tumb. Plast. Reconstr. Surg, 1968, 42, 374–377.

5. Nejedlý, A., Tvrdek, M., Stehlík, J. Závěrečná zpráva grantu IGA MZ ČR 1651-3 „Význam užití časných tkáňových přenosů při komplexní léčbě defektních poranění dolní končetiny“. Praha: 3. LF UK, 1995, 86.

6. Nejedlý, A. (Ed) Základy replantační chirurgie. Praha: Grada Publishing, 2003, 125.

7. Salvana, J., Rodner, C., Browner, B. D., Livingston, K., Schreiber, J., Pesanti, E. Chronic osteomyelitis: results obtained by an integrated team approach to management. Conn. Med., 2005, 69, 195–202.

8. Tvrdek, M., Nejedlý, A., Kletenský, J., Kufa, R. Treatment of chronic osteomyelitis of the lower extremity using free flap transfer. Acta. Chir. Plast., 1999, 41, 46–49.

Surgery Orthopaedics Trauma surgery
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account