Orthoplastic Surgery: A Practical Approach to Limb Salvage.

J Am Acad Orthop Surg · Jun 24 2026 · Recent

Barrera J, Levine J, Levin LS, Hacquebord J

From the Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, PA

Orthopaedic Oncology

SUMMARY — THE REDUCTIONOrthoplastic protocols combining orthopedic and plastic surgical principles reduce time to fixation and coverage, decreasing infection risk and improving limb salvage outcomes.
Abstract, as published

Complex extremity wounds, if not addressed properly, are a leading cause of major limb amputation. Chronic wounds in salvaged extremities contribute to long-term morbidity in the extremity. Orthoplastic surgery treats limb-threatening conditions through the combined application of orthopaedic and plastic surgical principles, applied to clinical problems simultaneously. Key components include early stakeholder evaluation of the limb and patient and open collaborative communication between orthopaedic and plastic surgeons. Meticulous débridement at the time of presentation and careful selection of fixation informed by the overall reconstructive plan should be executed when the patient presents to the emergency department. Implementation of Orthoplastic protocols results in quicker time to skeletal stabilization and soft tissue coverage, reduced risk of infection, improved functional outcomes, and less cost for care. This review presents a protocol-driven guide for establishing an Orthoplastic program and optimizing limb salvage outcomes across diverse practice settings.

Featured in the 2026-06-24 issue.

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