The reconstructive microsurgery ladder in orthopaedics

Scott M. Tintle, L. Scott Levin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Since the advent of the operating microscope by Julius Jacobson in 1960, reconstructive microsurgery has become an integral part of extremity reconstruction and orthopaedics. During World War I, with the influx of severe extremity trauma Harold Gillies introduced the concept of the reconstructive ladder for wound closure. The concept of the reconstructive ladder goes from simple to complex means of attaining wound closure. Over the last half century microsurgery has continued to evolve and progress. We now have a microsurgical reconstructive ladder. The microsurgical reconstruction ladder is based upon the early work on revascularization and replantation extending through the procedures that are described in this article.

Original languageEnglish
Pages (from-to)376-385
Number of pages10
Issue number3
StatePublished - 2013
Externally publishedYes


  • Brachial plexus
  • Flaps
  • Free fibula
  • Free tissue transfer
  • Medial femoral condyle flap
  • Microsurgery


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