The Art of Microsurgical Hand Reconstruction

摘要

As a service to our readers, Plastic and Reconstructive Surgery® reviews books, DVDs, practice management software, and electronic media items of educational interest to reconstructive and aesthetic surgeons. All items are copyrighted and available commercially. The Journal actively solicits information in digital format (e.g., CD-ROM and Internet offerings) for review. Reviewers are selected on the basis of relevant interest. Reviews are solely the opinion of the reviewer; they are usually published as submitted, with only copy editing. Plastic and Reconstructive Surgery® does not endorse or recommend any review so published. Send books, DVDs, and any other material for consideration to: Ronald P. Gruber, M.D., Review Editor, Plastic and Reconstructive Surgery, UT Southwestern Medical Center, 5959 Harry Hines Boulevard, POB1, Suite 300, Dallas, Texas 75390-8820. Ronald P. Gruber, M.D. Review Editor Dr. Slutsky is to be congratulated for recruiting a generous stable of internationally known and respected microneurovascular reconstructive surgeons to deliver a content-rich but somewhat labyrinthine atlas of complex operative procedures of the upper extremity. Each chapter is richly photodocumented, with highly stylized and colorful illustrations in many chapters that mostly serve to amplify procedural details or underscore anatomic principles. The curious practicing hand surgeon, postgraduate fellow, surgical resident, and medical student will all find material relevant to their needs in regard to this most challenging region of the body.FigureThe text is heavily weighted toward procedures designed for restoration of neurological deficits in the form of sensory restoration, nerve transfer or reconstruction, and brachial plexopathy repair. In this regard, the title might better include the words “Microneurovascular Reconstruction.” As well, as in all comprehensive texts in this field, inevitably and correctly, surgical offerings include restoration of function and wound repair of the entire upper extremity. Again, the title might better reflect the contents of the book if it were to include the entire anatomic region. Several procedures described do not involve microsurgical techniques in the strictest sense of the word. Cumulatively then, the title unnecessarily restricts the broad reach of the author’s intent, as this is truly an atlas of complex reconstruction of the upper extremity. “Art” is in the eye of the beholder and would be better left to the purchaser’s interpretation as opposed to the author’s or publisher’s declaration. Content is king in this atlas, and it is well ordered by the editor’s instructions to utilize a logical and familiar format of indications, contraindications, examination and imaging, relevant anatomy, pearls, pitfalls, surgical technique, outcomes, and variations. Rarely, odd chapters appear which necessarily break that sequence, such as “Brachial Plexus: Use of the Da Vinci Robot.” A very brief introductory chapter by Dr. Slutsky, revealing his recommendations as to how we can most effectively think about complex upper extremity injuries and how then to most effectively utilize his work, is surprisingly absent. There are other redundancies and format inconsistencies worth noting, such as the repetitive presentation of the anterolateral thigh flap in chapters 37 and 42 as well as the latissimus dorsi flap in chapters 37 and 39. Chapter 37 presents three particular flaps together for no apparent reason. Chapter 45, “Surgery for Vasospastic Disorders,” is assigned to the section on flaps without explanation. Section VII, the final section, entitled “Salvage,” leads off with two chapters, “Spinal Injury Classification” and “Direct Muscle Neurotization,” which might be better served in section III, “Brachial Plexus.” The remaining chapters in that last section would more accurately be grouped under the more familiar heading of digital replantation and toe transfer restoration and reconstruction. Finall