<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0376-7892</journal-id>
<journal-title><![CDATA[Cirugía Plástica Ibero-Latinoamericana]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. plást. iberolatinoam.]]></abbrev-journal-title>
<issn>0376-7892</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0376-78922024000300015</article-id>
<article-id pub-id-type="doi">10.4321/s0376-78922024000300015</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Reconstrucción de traumatismo complejo de extremidad superior. Caso clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[Complex reconstruction after upper extremity trauma. Case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Telich-Tarriba]]></surname>
<given-names><![CDATA[José E]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivera-Del Río]]></surname>
<given-names><![CDATA[Alexa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández-Palomo]]></surname>
<given-names><![CDATA[Justino]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ávila-Salgado]]></surname>
<given-names><![CDATA[Adriana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Pérez]]></surname>
<given-names><![CDATA[Miguel Ángel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cárdenas-Mejía]]></surname>
<given-names><![CDATA[Alexander]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Ángeles Pedregal Departamento de Cirugía Plástica y Reconstructiva ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Panamericana Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Médico ABC Departamento de Ortopedia y Traumatología ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Centro Médico ABC Departamento de Ortopedia y Traumatología ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Centro Médico ABC Departamento de Cirugía Vascular ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital General Dr. Manuel Gea González División de Cirugía Plástica y Reconstructiva ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2024</year>
</pub-date>
<volume>50</volume>
<numero>3</numero>
<fpage>347</fpage>
<lpage>350</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922024000300015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922024000300015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922024000300015&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El trauma complejo del miembro superior representa un desafío clínico que requiere una evaluación integral para abordar tanto la restauración funcional como la preservación estética de la extremidad. El objetivo de este artículo es generar una clara comprensión del abordaje para la reconstrucción de la extremidad en dos etapas. Presentamos el caso de una paciente con trauma complejo de extremidad superior izquierda secundario a accidente vehicular. Realizamos reconstrucción en dos etapas que incluyó cobertura cutánea del defecto con colgajo anterolateral de muslo, reconstrucción de lesión del nervio radial, y reconstrucción del húmero con peroné vascularizado. Tanto la recuperación funcional como el resultado estético fueron adecuados y aceptables para equipo médico y paciente. Este plan quirúrgico permite la reconstrucción adecuada de la extremidad superior con contaminación y conminución graves. Debe recibir un manejo multidisciplinario por la combinación de lesión vascular y de tejidos blandos, así como de un probable involucro de hueso y nervio periférico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Complex trauma of the upper extremity represents a clinical challenge that requires a comprehensive assessment to address both functional restoration and aesthetic preservation of the region. The main objective of this article is to provide a clear understanding of the approach to two-stage upper limb reconstruction. The case of a patient with complex trauma to the left upper extremity secondary to a vehicular accident is presented. A two-stage reconstruction was performed, including stabilization of the humeral fracture, defect coverage with an anterolateral thigh flap and repair of the radial nerve. Both, the functional recovery and the aesthetic outcome were suitable and acceptable to the medical team and the patient. This surgical plan allows for the proper reconstruction of the upper extremity with severe contamination and comminution. It should undergo multidisciplinary management due to the combination of vascular and soft tissue injury, along with probable involvement of bone and peripheral nerve.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Complex upper extremity trauma]]></kwd>
<kwd lng="en"><![CDATA[Upper extremity reconstruction]]></kwd>
<kwd lng="en"><![CDATA[Anterolateral thigh flap]]></kwd>
<kwd lng="en"><![CDATA[Nerve repair]]></kwd>
<kwd lng="es"><![CDATA[Trauma complejo extremidad superior]]></kwd>
<kwd lng="es"><![CDATA[Reconstrucción extremidad superior]]></kwd>
<kwd lng="es"><![CDATA[Colgajo anterolateral muslo]]></kwd>
<kwd lng="es"><![CDATA[Reparación nervio]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Telich-Tarriba]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Velazquez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Theurel-Cuevas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Shinji-Perez]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Anaya-Ayala]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Jimenez-Murat]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Cardenas-Mejia]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Upper Extremity Patterns of Injury and Management at a Plastic and Reconstructive Surgery Referral Center in Mexico City]]></article-title>
<source><![CDATA[Ann Plast Surg]]></source>
<year>2018</year>
<volume>80</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>23-6</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Telich-Tarriba]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Santos-Gallegos]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Cardenas-Mejia]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Arroyo-Berezowsky]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Characteristics of fingertip injuries and proposal of a treatment algorithm from a hand surgery referral center in Mexico City]]></article-title>
<source><![CDATA[Acta Chir Plast]]></source>
<year>2021</year>
<volume>63</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>113-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lopez]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Estrada]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Repercusión ocupacional de las amputaciones traumáticas en dedos de la mano por accidente de trabajo]]></article-title>
<source><![CDATA[Med Segur Trab]]></source>
<year>2009</year>
<volume>55</volume>
<page-range>41-4</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Valenzuela Flores]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
</person-group>
<source><![CDATA[Diagnóstico y Manejo Integral de las lesiones traumáticas de Mano en el Adulto. Evidencias y Recomendaciones]]></source>
<year>2015</year>
<page-range>9-11</page-range><publisher-loc><![CDATA[Mexico city ]]></publisher-loc>
<publisher-name><![CDATA[Ed. Instituto Mexicano del Seguro Social. Catálogo Maestro de Guías de Práctica Médica]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mahajan]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Srinivasan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Jain]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bhamre]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Narayan]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of Complex Upper Extremity Trauma with Associated Vascular Injury]]></article-title>
<source><![CDATA[Indian J. Plast. Surg]]></source>
<year>2022</year>
<volume>55</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>224-33</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[de Putter]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
<name>
<surname><![CDATA[Selles]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Haagsma]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Health-related quality of life after upper extremity injuries and predictors for suboptimal outcome]]></article-title>
<source><![CDATA[Injury]]></source>
<year>2014</year>
<volume>45</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1752-8</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Starnoni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Benanti]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Acciaro]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[De Santis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Upper limb traumatic injuries: A concise overview of reconstructive options]]></article-title>
<source><![CDATA[Ann. Med. Surg]]></source>
<year>2021</year>
<volume>66</volume>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rush Jr]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Arrington]]></surname>
<given-names><![CDATA[ED]]></given-names>
</name>
<name>
<surname><![CDATA[Hsu]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of complex extremity injuries: tourniquets, compartment syndrome detection, fasciotomy, and amputation care]]></article-title>
<source><![CDATA[Surg Clin North Am]]></source>
<year>2012</year>
<volume>92</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>987-1007</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stefano]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Giovanni]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Pietro]]></surname>
<given-names><![CDATA[DF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Which is the best score and classification system for complex injuries of the limbs? Some recommendations based on a systematic literature review]]></article-title>
<source><![CDATA[Eur J Plast Surg]]></source>
<year>2022</year>
<volume>45</volume>
<page-range>551-60</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ng]]></surname>
<given-names><![CDATA[ZY]]></given-names>
</name>
<name>
<surname><![CDATA[Askari]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chim]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Approach to complex upper extremity injury: an algorithm]]></article-title>
<source><![CDATA[Semin Plast Surg]]></source>
<year>2015</year>
<volume>29</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>5-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hagiga]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ali]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Functional and Aesthetic Outcomes of the Anterolateral Thigh Flap in Reconstruction of Upper Limb Defects: A Systematic Review]]></article-title>
<source><![CDATA[WJPS]]></source>
<year>2022</year>
<volume>11</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>13-23</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[de la Parra-Márquez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zorola-Tellez]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Cárdenas-Rodríguez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rangel-Flores]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez-Terrones]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Versatilidad del colgajo microvascular de peroné en reconstrucción de extremidades]]></article-title>
<source><![CDATA[Cir Cir]]></source>
<year>2016</year>
<volume>84</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>213-9</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Patterson]]></surname>
<given-names><![CDATA[JMM]]></given-names>
</name>
<name>
<surname><![CDATA[Russo]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[El-Haj]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Novak]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
<name>
<surname><![CDATA[Mackinnon]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function]]></article-title>
<source><![CDATA[Hand (NY)]]></source>
<year>2022</year>
<volume>17</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1082-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bertelli]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nerve Versus Tendon Transfer for Radial Nerve Paralysis Reconstruction]]></article-title>
<source><![CDATA[J Hand Surg Am]]></source>
<year>2020</year>
<volume>45</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>418-26</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
