Standardised emergency management protocols for hand injury in microsurgery is critical, as it directly determines ultimate clinical outcomes. This consensus consolidates expert insights regarding diagnostic and treatment procedure for hand injury in microsurgery, emergency support protocols and key points of emergency workflow optimisation. It summarises the opinions of experts and puts forward standardised recommendations to guide clinical practice in microsurgical treatment process, so as to further improve the quality of treatment for hand injury in microsurgery and maximise the protection of limb function and quality of life of patients.

Standardised emergency management protocols for hand injury in microsurgery is critical, as it directly determines ultimate clinical outcomes. This consensus consolidates expert insights regarding diagnostic and treatment procedure for hand injury in microsurgery, emergency support protocols and key points of emergency workflow optimisation. It summarises the opinions of experts and puts forward standardised recommendations to guide clinical practice in microsurgical treatment process, so as to further improve the quality of treatment for hand injury in microsurgery and maximise the protection of limb function and quality of life of patients.

This paper reports a successful limb salvage and fetal preservation in the Department of Orthopaedic Surgery, Zhengzhou Renji Hospital, for a 31-year old pregnant woman who was in the second trimester of pregnancy and suffered a severe destructive injury of left lower limb in July 2019. After thorough debridement and proper fracture fixation, microsurgical and Ilizarove techniques were applied to reconstruct bone and large soft tissue defects as well as the limb functions. Postoperative rehabilitation was conducted. A boy was delivered by cesarean section at 35 weeks. Osteotomy of femur, tibia and fibula and fixation with external fixator were performed at 6 months after surgery. The femoral external fixator was removed at 11 months after surgery, and the calf external fixator was removed at 18 months after surgery. At the 3-year postoperative follow-up, the boy was in good intellectual development, and had good appearance and satisfactory functional recovery of the affected lower limb.

This paper reports a successful limb salvage and fetal preservation in the Department of Orthopaedic Surgery, Zhengzhou Renji Hospital, for a 31-year old pregnant woman who was in the second trimester of pregnancy and suffered a severe destructive injury of left lower limb in July 2019. After thorough debridement and proper fracture fixation, microsurgical and Ilizarove techniques were applied to reconstruct bone and large soft tissue defects as well as the limb functions. Postoperative rehabilitation was conducted. A boy was delivered by cesarean section at 35 weeks. Osteotomy of femur, tibia and fibula and fixation with external fixator were performed at 6 months after surgery. The femoral external fixator was removed at 11 months after surgery, and the calf external fixator was removed at 18 months after surgery. At the 3-year postoperative follow-up, the boy was in good intellectual development, and had good appearance and satisfactory functional recovery of the affected lower limb.

Reports a case admitted in the Ward I of Department of Surgery of Zhengzhou Renji Hospital in June 2017. A young child who suffered destructive injury of left forearm, wrist and palm with severed 3rd-5th fingers. Tendon and neurovascular repairs of forearm, wrist and palm were performed with pedicled abdomina flap and the 3rd-5th fingers ectopic replantation in Phase I surgery. In the Phase II surgery, the abdomina flap division was carried out. The replantation of severed fingers after ectopic replantation and the reconstruction of foot defect with free anterolateral thigh flap(ALTF) were carried out in Phase III surgery. In Phase IV surgery, fingers functional reconstruction and foot flap thinning were performed. Four years after surgery, the thumb oppositions to middle, ring and little fingers could be completed, with slightly limitations. The appearance and texture of transferred foot flap were good, and the child could walk and run almost normally.

A case of a 3-year-old child suffered with severe crush injury to the right forearm and right hand on June, 2017. A comprehensive treatment was conducted with limb salvage, free flap repair and the repair of nerve, vessel and tendon for functional reconstructions followed by rehabilitation therapies. The function and appearance of the injured limb and hand recovered well 3 years after surgery.