Alexander Lerner Bücher

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 cause significant damage to soft tissue and bone, necessitating immediate external fixation and thorough debridement due to contamination. The subsequent treatment phase involves covering exposed bone with vital soft tissue and achieving definitive skeletal stabilization, which poses complex surgical challenges. The authors present a protocol for staged external fixation, beginning with primary temporary unilateral tubular stabilization, followed by definitive circular Ilizarov (hybrid) fixation. This comprehensive guide serves both young and senior orthopedic trauma surgeons in the staged reconstruction of limb function. It details the rationale and advantages of a logical progression of surgical steps, supported by an extensive collection of clinical photographs and X-ray documentation illustrating each treatment phase across various complex cases, including significant bone and soft tissue loss. Drawing on 40 years of experience in managing severe musculoskeletal injuries, particularly war-related trauma, the text emphasizes the importance of soft tissue care, sequential damage control, and the strategic use of external fixation.