ABSTRACT
It was Sterling Bunnell who said that trauma to the limb involves all types of tissue, irrespective of the divisions of surgical specialties that perform upper extremity surgery (Bunnell 1970). Therefore we believe, among others, that the combination of specialties, as represented in the orthoplastic approach, permits the best possible outcome in the treatment of the mangled upper extremity (Green 1994, Gopal et al 2000). The orthoplastic approach combines the best of two surgical specialists: the orthopedic surgeon with training and practice traditionally dedicated to the care of bone and joint injuries and the reconstructive plastic surgeon with expertise in soft tissue coverage and resurfacing (Levin 1993). Many recent advantages in reconstructive surgery have permitted greater salvage and more rapid restoration of the structure and function of injured upper extremity (Vasconez 1993). Stabilization, fixation and distraction of bony segments have been a key element in improving results. No less important has been the demonstration that rapid and optimal soft tissue reconstruction has a direct impact on the treatment of the limb as a whole.
