Orthoplastic surgery, a multidisciplinary approach to addressing complex, traumatic reconstruction, has grown significantly since its emergence over three decades ago. Its success in improving both functional and reconstructive outcomes has led to an increased demand for orthoplastic surgeons and the development of dedicated limb salvage programs at institutions around the world. This review outlines the development of a multidisciplinary orthoplastic surgery program at a Level 1 trauma center in the United States, which serves as a major tertiary referral hub for complex extremity trauma and reconstruction. Central to the success of this practice is collaboration between multiple surgical and medical subspecialists. Coordination of our program is enhanced through center-supported staff such as nurse navigators and practice managers. The goal of this review article is to highlight the foundations that our program is built on and provide a framework for other institutions to emulate when establishing an orthoplastic surgery program.

Currently, there is a growing number of lawsuits from patients, primarily those with Biocell breast implants, against the surgeons who performed the procedures. This is partly due to law firms actively seeking out affected individuals to pursue claims for damages based on allegedly inadequate disclosure of the risk of BIA-ALCL. The unsuccessful attempts to obtain financial compensation through product liability and proof of a defective medical device may also contribute to this trend. This raises the question of when a surgeon could reasonably be expected to disclose the associated risks.

Scapholunate ligament injuries are the most common ligamentous injuries of the wrist and typically result from high-energy trauma, most often following a fall onto the outstretched hand. This comprehensive review summarizes the current knowledge regarding scapholunate ligament injuries, including anatomy, pathophysiology, diagnostic approaches, and management strategies. Scapholunate ligament injuries primarily affect individuals aged 20-50 years, with male patients at higher risk due to participation in high-impact activities. Despite their prevalence, these injuries are challenging to diagnose due to subtle clinical presentations and limitations of imaging modalities, often leading to delayed recognition and progression to scapholunate advanced collapse, a severe form of wrist arthritis. The scapholunate ligament plays a critical role in maintaining wrist stability, with its dorsal component being biomechanically most important. Pathophysiology ranges from partial tears causing dynamic instability to complete disruptions leading to static malalignment and degenerative changes. Advances in diagnostic modalities, including high-resolution magnetic resonance imaging, wrist arthroscopy, and dynamic computed tomography or ultrasonography, have improved detection. Meanwhile, classification systems like Geissler, Mayo and Garcia-Elias help guide treatment strategies. Management is determined by injury severity and chronicity. Conservative approaches, such as immobilization and physical therapy, are effective for partial injuries, while surgical interventions, including ligament repair, reconstruction, and salvage procedures, are reserved for more severe cases. Newer arthroscopic techniques, biological augmentations, and minimally invasive approaches have improved outcomes and reduced complication rates. Rehabilitation and long-term follow-up remain essential to optimize recovery and monitor for degenerative changes. Emerging technologies, including dynamic implants and artificial intelligence for diagnostics, promise further advances. Nevertheless, early diagnosis and timely intervention remain critical to preventing chronic dysfunction and improving patient quality of life.

The cosmetic surgery sector in Australia underwent a significant regulatory transformation between 2020 and 2025 following sustained media, professional, and governmental scrutiny. A series of high-profile investigative reports by the ABC Four Corners, Nine Network's 60 Minutes, The Age, and The Sydney Morning Herald revealed systemic deficiencies in clinical oversight, advertising ethics, and patient safety within the cosmetic surgery industry. Public concerns, amplified by evidence of patient harm and misleading practitioner claims, prompted legislative amendments to the Health Practitioner Regulation National Law (Surgeons) Amendment Act 2023 and a comprehensive review of the cosmetic surgery framework by the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia (MBA). This paper analyses the legislative, regulatory, and legal reforms introduced from 2020 to 2025, situating them within the broader context of developments in patient protection, title regulation, and professional accountability. Using document analysis and legal review methods, this paper synthesises statutory changes, Federal Court decisions, and the evolving role of professional colleges in the regulation of medical titles. The findings demonstrate that enhanced patient protection has been achieved through title restriction, stricter advertising regulation, and expanded public access to information about medical practitioners. However, tensions persist regarding the recognition of subspecialisation and professional identity, particularly within the context of multidisciplinary surgical practice.

Groundbreaking technological advances in plastic and orthopedic surgery have contributed to substantially increasing the overall limb-salvage rates over recent decades. Adequate reconstruction of complex tissue defects of diverse etiologies - including traumatic, oncologic, ischemic, and infectious causes - has become highly feasible through the application of advanced reconstructive techniques and plays a pivotal role in preserving limb function and markedly improving patients' quality of life. The success of such complex reconstructive strategies requires a multidisciplinary team capable of integrating diverse surgical competencies - such as skeletal stabilization, soft-tissue coverage, and vascular reconstruction - into a coherent treatment pathway. Orthoplastic surgery is founded on the close collaboration between orthopedic surgeons and plastic-reconstructive microsurgeons, whose complementary expertise facilitates both the execution of intricate reconstructions and a well-founded assessment of limb-salvage potential. This article outlines the roles of orthopedic and plastic-reconstructive surgeons as core pillars of an orthoplastic care model and illustrates how this interdisciplinary approach can address the multifaceted challenges in limb reconstruction.

Minimally invasive osteosynthesis techniques have gained widespread acceptance in the surgical management of extremity fractures due to their potential to reduce complication rates and enhance both wound and fracture healing. Ongoing development and validation of novel techniques and surgical approaches have allowed for a continuous expansion of indications. In addition, emerging technologies such as computer-assisted navigation and three-dimensional planning - utilizing patient-specific, 3D-printed reduction guides and implants - are expected to further expand and refine minimally invasive approaches in the future. Nevertheless, appropriate indication and a precise understanding of regional anatomy remain critical to avoid complications such as nerve injuries or nonunion resulting from inadequate osteosynthesis.

Orthoplastic surgery integrates principles of trauma surgery and microsurgery to achieve functional restoration in complex limb injuries. While osseous stabilization and soft-tissue coverage have long been established as core components, the importance of early reconstruction of peripheral nerves within the orthoplastic treatment concept is increasingly recognized. The aim of this study is to systematically outline the principles of peripheral nerve surgery in the orthoplastic context.A scoping review was performed with a systematic search of the literature on peripheral nerve surgery in orthoplastic procedures, followed by a narrative synthesis. Original studies, reviews, case series, and clinical guidelines published between 1990 and 2025 were included. The focus was on nerve reconstruction, nerve transfers, neurotized flaps, and strategies for pain prevention in amputations.Peripheral nerve injuries frequently occur as associated injuries in high-energy trauma and have a substantial impact on functional outcomes. Early assessment by peripheral nerve surgeons is essential, as the time window for successful motor reinnervation is limited. In addition to primary repair and autologous nerve grafting, nerve transfers and tendon transfer procedures are increasingly used to achieve functional reconstruction. Neurotized flap procedures, particularly for plantar defect reconstruction, can improve protective sensation and prevent late complications. In major amputations, prophylactic nerve transfers have been shown to reduce the incidence of chronic pain syndromes and to improve prosthetic usability.Peripheral nerve surgery is a key component of orthoplastic care. Its early integration into interdisciplinary treatment algorithms is crucial for long-term functional outcomes. Future studies should aim to standardize indications, techniques, and timing.