[Restoration of replanted extremity function with use of microsurgical tissue autotransplantation].

The results of 40 tissue autotransplantations for correction of function of the replanted upper extremities. The peculiar features of vascularised tissue autotransplantation in specific situations of anatomic and morphologic changes in replanted upper extremities are presented. It was proved, that vascularised tissue autotransplantation is a safe and effective method for restoration of function of the extremities, replanted after traumatic amputation, that was accompanied with massive tissue damages.

Flap transfer for complications of major limb replantation.

Our experience in the management of necrotizing and suppurating wound complications after major upper extremity replantation is presented. Seven patients underwent wound debridement and coverage with flaps. Of these, 6 were reconstructed with latissimus dorsi flaps and 1 with the scapular flap.

Rehabilitation of patients after lower limb replantations by the bone distraction method.

The length of the lower extremities was equalized by the bone distraction method in four patients after replantation of lower legs. A Volkov-Oganesian or Ilizarov distraction apparatus was applied on the replanted lower leg after corticotomy of the tibia and osteotomy of the fibula, and distraction was carried out over 6 to 11 months in small, measured doses. The lower extremities were lengthened from 4 to 8 cm.

Successful replantation of the lower leg after 42-hour ischemia: case report.

A case of right lower-leg replantation after 42-hr ischemia is presented. Revascularization of the other foot with circulatory decompensation after 36-hr ischemia was carried out simultaneously. The replanted lower leg survived.

Reconstruction of a complex defect of the hand with two distinct segments of the scapula and a scapular fascial flap transferred as a single transplant.

To repair multiple defects of the metacarpal bones in combination with skin defects, a combined scapular free flap on a single vascular pedicle--the subscapular artery and the accompanying veins--can be used successfully. This flap includes two distinct bone segments of the lateral border of the scapula and a scapular fascial flap. Because of its long and mobile vascular pedicle, such a transplant can be used for one-stage reconstruction of the first and other metacarpal bones of the long fingers of the hand.

[Plastic surgery of combined cutaneo-osseous defects of the hand].

The article analyses modern methods for the restoration of of defects in the metacarpal bones, based on microsurgical techniques. A case is described in which a new method for one-stage reconstruction of the hand in combined traumatic defect in the first and second metacarpal bones and an extensive defect in the soft tissues on the back of the hand was used. The hand was reconstructed by means of a vascularized complex autograft on a common vascular pedicle which included two separate fragments of the scapula and a fascial flap of the scapular region.

[Duration of anoxia during replantation of large segments of the extremities].

Experience in 155 replantations of large segments of the extremities is discussed. The results of treatment are analysed from the standpoint of anoxia of the separated segments of the extremities. A case of replantation of the lower extremity (shin) with 42-hour anoxia is described.