Soft Tissue Coverage of the Hand and Upper Extremity: The Reconstructive Elevator.

Area of Science:

• Orthopedics
• Plastic Surgery
• Reconstructive Surgery

Background:

• Soft tissue defects in the upper extremity present complex reconstructive challenges.
• Traditional 'reconstructive ladder' approach favors simpler solutions.
• Emerging 'reconstructive elevator' concept allows for more complex options.

Purpose of the Study:

• To present an algorithm for assessing upper extremity soft tissue defects.
• To highlight the benefits of the reconstructive elevator concept.
• To provide a framework for optimizing functional and aesthetic outcomes.

Main Methods:

• Review of current literature on soft tissue reconstruction.
• Presentation of a defect assessment algorithm.
• Illustrative case examples (6) demonstrating key concepts.
• Discussion of representative flap options.

Main Results:

• The reconstructive elevator allows for tailored reconstruction based on functional and aesthetic goals.
• An algorithmic approach aids in defect assessment and solution selection.
• Case examples illustrate successful application of advanced reconstructive techniques.

Conclusions:

• The reconstructive elevator paradigm offers greater flexibility in managing upper extremity defects.
• A systematic approach enhances the ability to achieve patient and surgeon goals.
• Optimizing both function and aesthetics is achievable with advanced reconstructive strategies.