Modern weapons and high-energy accidents inflict devastating damage to soft tissue and bone. The gold standard for stabilizing high-energy fractures is immediate external fixation followed by thorough debridement of soft tissues and dead bone and irrigation, since these injuries are always grossly contaminated. The next stage of treatment – the coverage of exposed bone by vital soft tissue and definitive skeletal stabilization and reconstruction – can be a complex surgical challenge. The protocol of staged external fixation developed by the authors: primary temporary unilateral tubular stabilization followed by definitive circular Ilizarov (hybrid) fixation, is outlined and comprehensively described in this book. The text provides guidelines for the young surgeon as well as the senior orthopedic trauma surgeon in staged definitive limb functional reconstruction. The rationale and advantages of a logical progression of surgical steps are explained and fully illustrated throughout, drawing from an archive of clinical photographs and X-ray documentation covering all steps of the treatment protocol in a large variety of complex cases, including extensive bone and soft tissue loss. This practical guide is based on the accumulated experience of 40 years in the treatment of severe injuries of the musculoskeletal system with grave tissue loss, and in particular war injuries. Emphasis is given to the proper attention and care of the soft tissues, sequential damage control, and the judicious staged use of appropriate external fixation.

This book is designed to meet the continued need to re-learn the principles of treatment of complex war injuries to the extremities in order to minimize post-traumatic and post-treatment complications and optimize functional recovery. Most of the chapters are based on the unique experience gained in the treatment of military personnel who have suffered modern combat trauma and civilian victims of terror attacks at a single, large level 1 trauma center. The remaining chapters present the experience of leading international authorities in trauma and reconstructive surgery. A staged treatment protocol is presented, ranging from primary damage control through to definitive functional limb reconstruction. The organization of medical aid, anesthesiology, diagnostic imaging, infection prophylaxis, and management of complications are reviewed, and a special chapter is devoted to the challenging dilemma of limb salvage versus amputation in the treatment of limbs at risk.

Modern weapons and high-energy accidents inflict devastating damage to soft tissue and bone. The gold standard for stabilizing high-energy fractures is immediate external fixation followed by thorough debridement of soft tissues and dead bone and irrigation, since these injuries are always grossly contaminated. The next stage of treatment – the coverage of exposed bone by vital soft tissue and definitive skeletal stabilization and reconstruction – can be a complex surgical challenge. The protocol of staged external fixation developed by the authors: primary temporary unilateral tubular stabilization followed by definitive circular Ilizarov (hybrid) fixation, is outlined and comprehensively described in this book. The text provides guidelines for the young surgeon as well as the senior orthopedic trauma surgeon in staged definitive limb functional reconstruction. The rationale and advantages of a logical progression of surgical steps are explained and fully illustrated throughout, drawing from an archive of clinical photographs and X-ray documentation covering all steps of the treatment protocol in a large variety of complex cases, including extensive bone and soft tissue loss. This practical guide is based on the accumulated experience of 40 years in the treatment of severe injuries of the musculoskeletal system with grave tissue loss, and in particular war injuries. Emphasis is given to the proper attention and care of the soft tissues, sequential damage control, and the judicious staged use of appropriate external fixation.

This book is designed to meet the continued need to re-learn the principles of treatment of complex war injuries to the extremities in order to minimize post-traumatic and post-treatment complications and optimize functional recovery. Most of the chapters are based on the unique experience gained in the treatment of military personnel who have suffered modern combat trauma and civilian victims of terror attacks at a single, large level 1 trauma center. The remaining chapters present the experience of leading international authorities in trauma and reconstructive surgery. A staged treatment protocol is presented, ranging from primary damage control through to definitive functional limb reconstruction. The organization of medical aid, anesthesiology, diagnostic imaging, infection prophylaxis, and management of complications are reviewed, and a special chapter is devoted to the challenging dilemma of limb salvage versus amputation in the treatment of limbs at risk.