Limb salvage surgery and limb restoration

What is limb salvage surgery and limb restoration?

Limb salvage surgery focuses on saving a severely injured or diseased limb at risk of amputation, while limb restoration is aimed at improving the quality of a damaged limb that is not functioning well but does not necessarily need removal. Both treatments may include surgical procedures that address limited motion, nerve damage, pain, and severe scarring.

At Penn Medicine Orthopaedics, our surgeons are internationally recognized for their expertise in advanced techniques for limb salvage and limb restoration. We use innovative approaches, such as microsurgery, to treat complex trauma cases and conditions like bone or soft tissue tumors. Our team is highly experienced in managing infections and performing surgeries that save limbs, reduce pain, preserve or restore function, and help people return to their daily activities.

How limb salvage and restoration surgeries work

Limb salvage and restoration surgeries use advanced techniques to repair and rebuild injured or damaged limbs by reconstructing bones, repairing soft tissue, and reconnecting blood vessels and nerves. Surgical methods include:

  • Surgical debridement: In cases of severe infection, infected or dead tissue may be removed to save the limb or improve its condition.
  • Bone reconstruction: Bone grafts or synthetic implants may be used to replace or repair damaged bone. Metal plates, screws, or rods are often inserted to stabilize the bone and improve limb function.
  • Microvascular surgery: This subspecialty of microsurgery is performed using an operating microscope and sutures small enough to pass through a human hair. In reconstructive surgery, microvascular surgeons are able to restore form and function by grafting soft tissue and repairing nerves and blood vessels.

Who is a candidate for limb salvage surgery or limb restoration?

Candidates for limb salvage surgery or limb restoration usually have serious damage from trauma or disease, but they may differ in the degree of damage, recency of trauma, and urgency of treatment.

What to expect from limb salvage surgery or limb restoration

The details of your limb salvage surgery or limb restoration will depend on your specific condition and treatment plan, which your doctor will discuss with you. However, there are several common steps in the process:

  • Initial consultation and evaluation: Your surgeon will evaluate the damage to your limb using imaging studies like x-rays, MRIs, or CT scans. This will help in planning the best surgical approach.
  • Surgery: Depending on the specific issue, your surgery may involve multiple procedures. This includes addressing any infections, removing damaged tissues or tumors, and repairing or reconstructing bone and soft tissues. To keep you pain-free during surgery you’ll receive a general anesthesia that puts you to sleep or a regional anesthesia that completely numbs the limb.
  • Hospital stays: After surgery, most people stay in the hospital for a few days to recover. The length of the stay depends on the complexity of the procedure and your overall health.
  • Postsurgical care: Regular follow-up examinations are important to monitor healing and ensure the limb is functioning properly.

Recovery from limb salvage surgery or limb restoration

The length and stages of your recovery will vary based on the complexity of the surgery and whether the procedure was performed on an arm or leg.

  • For arms: Recovery may involve wearing a splint or cast to protect the limb. Physical therapy will focus on regaining strength, range of motion, and fine motor skills.
  • For legs: Weight-bearing activities may be limited for several weeks to months, and you are likely to need crutches or a walker during the early stages of recovery. Physical therapy will focus on improving your walking ability and regaining leg strength.

It’s normal to experience pain around the surgery site during the first few weeks after the procedure. Your doctor will provide a pain management plan that may involve prescription or over-the-counter medications. As you recover, you’ll gradually reduce the need for medication. Full recovery may take several months to a year, depending on the complexity of the surgery and your overall health. Physical therapy is essential to help you regain strength, mobility, and function.

Risks of limb salvage surgery and limb restoration

As with any surgery, there are risks involved in limb salvage surgery or limb restoration. Potential complications include:

  • Infection: There’s always a risk of infection after surgery, especially in cases where large areas of tissue are repaired.
  • Nerve damage: While the goal is to repair or preserve nerves, there is a risk of further nerve damage, which can result in loss of sensation or chronic pain.
  • Blood clots: Post-surgery immobility can increase the risk of developing blood clots, particularly in the legs.
  • Delayed healing: Bone or tissue may not heal properly, leading to additional surgeries or longer recovery times.
  • Scar tissue: Excessive scar tissue can form after surgery, which may limit the range of motion in the affected limb.

Your care team will explain your specific risks and take every precaution to help minimize them. They’ll monitor you closely after surgery and in follow-up visits.

Trust the experts in limb preservation and restoration

The only program of its kind in the United States, Penn Medicine’s Orthoplastic Limb Salvage Center performs transformative surgeries for people who are at high risk of limb amputation or in need of functional limb restoration. Choosing Penn Medicine means putting your treatment in the hands of dedicated surgeons who are revolutionizing limb salvage and complex fracture care. We not only specialize in microsurgery, we performed the first microsurgical case in the country.

Our multidisciplinary team includes experts in the fields of orthopaedics, vascular surgery, plastic surgery, rehabilitation, diabetes management, infectious disease, prosthetics, orthotics, and more. They work together to develop a comprehensive, integrated treatment plan—one that honors your overall health, lifestyle, and personal goals.

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