Micro-surgical reconstruction of the hand and the forearm
Seance of wednesday 12 february 2025 (La Microchirurgie: les progrès récents)
DOI number : 10.26299/51mn-fr59/2025.06.05
Abstract
Reconstruction of the hand and the forearm, a broad and complex field of plastic, reconstructive and aesthetic surgery, has been swiftly evolving since the advent of microsurgery five decades ago, notably thanks to the techniques and indications of the amputated segment replantation, pedicle flaps and free flaps.
Complex tissue defects of the hand and/or the forearm, whether of a traumatic, infectious, or oncologic origin, may cause major functional and aesthetic disorders, requiring adequate, and most of the time, multidisciplinary care. Within this coordinated team, the plastic surgeon is in charge of reconstructing the limb, with the primary aim of securing quality soft tissue coverage and optimally restoring its function and aesthetic aspect, while minimising donor-site-related sequelae. Choosing the best therapeutic solution for each particular patient is a challenging task. To address it, the plastic surgeon must master the whole available therapeutic arsenal, ranging from conventional grafts to pedicle and free flaps; have a perfect understanding of the patient’s functional and aesthetic needs; and finally, have a clear vision of the multidimensional reconstruction of a given defect.
To account for the challenge that the reconstructive plastic surgeon must take up, having to face a variety of tissue defects as much as a variety of potential therapeutic solutions, we chose to approach the micro-surgical reconstruction of the hand and the forearm by focusing on the indications and the selection of the reconstructive techniques.
Complex tissue defects of the hand and/or the forearm, whether of a traumatic, infectious, or oncologic origin, may cause major functional and aesthetic disorders, requiring adequate, and most of the time, multidisciplinary care. Within this coordinated team, the plastic surgeon is in charge of reconstructing the limb, with the primary aim of securing quality soft tissue coverage and optimally restoring its function and aesthetic aspect, while minimising donor-site-related sequelae. Choosing the best therapeutic solution for each particular patient is a challenging task. To address it, the plastic surgeon must master the whole available therapeutic arsenal, ranging from conventional grafts to pedicle and free flaps; have a perfect understanding of the patient’s functional and aesthetic needs; and finally, have a clear vision of the multidimensional reconstruction of a given defect.
To account for the challenge that the reconstructive plastic surgeon must take up, having to face a variety of tissue defects as much as a variety of potential therapeutic solutions, we chose to approach the micro-surgical reconstruction of the hand and the forearm by focusing on the indications and the selection of the reconstructive techniques.