Semin Plast Surg 2025; 39(03): 129-139
DOI: 10.1055/s-0045-1810090
Cheng-Hung Lin
1
Department of Plastic and Reconstructive Surgery, Chang Gung Medical College and Chang
Gung University, Chang Gung Memorial Hospital, Taoyuan, Taiwan
2
Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital,
Taoyuan, Taiwan
,
Ying-Chao Chou
3
Department of Orthopedic Surgery, Chang Gung Medical College and Chang Gung University,
Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
Chung-Chen Hsu
1
Department of Plastic and Reconstructive Surgery, Chang Gung Medical College and Chang
Gung University, Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
Ren-Wen Huang
1
Department of Plastic and Reconstructive Surgery, Chang Gung Medical College and Chang
Gung University, Chang Gung Memorial Hospital, Taoyuan, Taiwan
2
Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital,
Taoyuan, Taiwan
,
Chih-Hung Lin
1
Department of Plastic and Reconstructive Surgery, Chang Gung Medical College and Chang
Gung University, Chang Gung Memorial Hospital, Taoyuan, Taiwan
2
Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital,
Taoyuan, Taiwan
› Author AffiliationsFunding This work was supported by Chang Gung Medical Foundation (grant nos.: CORPG3P0471
and CORPG3P0491). The funders had no roles in study design, data collection and analysis,
decision to publish, or preparation of the manuscript.
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Abstract
The orthoplastic approach to extremity reconstruction represents a paradigm shift
in the management of complex limb injuries, integrating orthopedic and plastic surgery
principles to optimize functional and aesthetic outcomes. This review examines the
evolution of this approach, its hierarchical framework for addressing tissue defects,
and the essential technical competencies required for successful implementation. Key
components of orthoplastic extremity reconstruction are illustrated through current
evidence focusing on soft tissue management with high free flap success rates, vascularized
bone transfers utilizing fibula, iliac crest, and medial femoral condyle flaps, and
advanced techniques for amputee reconstruction including regenerative peripheral nerve
interfaces and targeted muscle reinnervation. Meta-analysis evidence demonstrates
that the synergistic collaboration between orthopedic and plastic surgery specialties
achieves significant reduction in infection rates, improved limb salvage rates, and
decreased health care costs through reduced hospital stay and revision surgeries.
This article emphasizes the importance of multidisciplinary collaboration, comprehensive
preoperative planning, and technical expertise in achieving optimal results in complex
extremity reconstruction while addressing recent advances in reconstructive microsurgery
protocols.
Keywords
orthoplastic reconstruction -
extremity reconstruction -
vascularized bone transfer
Publication History
Article published online:
08 August 2025
© 2025. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
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