{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:20:51Z","timestamp":1790299251310,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2005,10,19]],"date-time":"2005-10-19T00:00:00Z","timestamp":1129680000000},"content-version":"vor","delay-in-days":4674,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[1993,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Multiple secondary grafting procedures may be necessary in cases of complete or partial amputation of the lower limb if the aim is to preserve the initial limb length. The traditional concept of staged reconstruction often leads to a prolonged hospitalisation and a high complication rate, especially in cases with segmental nerve defects of more than one major nerve and severe skin loss. To minimize multiple secondary operations of soft tissue and bone, we have developed the concept of primary shortening with secondary limb lengthening. We perform a primary shortening of the amputation stump and the severed limb at the time of replantation, in order minimize the skin defect and to undertake a primary wound closure and\/or primary nerve suture. Six to 12 months after replantation, secondary limb lengthening is started, using an external or internal distraction device. Since 1985, 7 patients presenting with complete or partial amputation of the lower leg had been treated using this concept. The indications, operative technique, complications and results are shown and discussed, comparing this new concept to the traditional concept with extensive free soft tissue transfer and secondary nerve grafting. \u00a9 1993 Wiley\u2010Liss Inc.<\/jats:p>","DOI":"10.1002\/micr.1920140706","type":"journal-article","created":{"date-parts":[[2007,3,4]],"date-time":"2007-03-04T21:35:48Z","timestamp":1173044148000},"page":"446-453","source":"Crossref","is-referenced-by-count":31,"title":["Primary shortening with secondary limb lengthening in severe injuries of the lower leg: A six year experience"],"prefix":"10.1002","volume":"14","author":[{"given":"A. M.","family":"Betz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Stock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hierner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Baumgart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,10,19]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"499","volume-title":"Technique du traitement des fractures","author":"B\u00f6nier L","year":"1944"},{"key":"e_1_2_1_3_2","volume-title":"Symposium: \u201cReplantation heute, Aktuelles and Perspektiven in der Replantationschirurgie\u201d","author":"Brunelli G","year":"1991"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02514890"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(10)80148-0"},{"key":"e_1_2_1_6_2","first-page":"43","article-title":"Preliminary studies of mineralization during distraction osteogenesis","volume":"244","author":"Aronson J","year":"1990","journal-title":"Clinical Orthopaedics and Related Research"},{"key":"e_1_2_1_7_2","first-page":"244","article-title":"Defektbehandlung langer R\u00f6hrenknochen durch Distraktions osteogenese (Ilizarow) und Marknagelung","volume":"93","author":"Brunner U","year":"1990","journal-title":"Unfallchirurgie"},{"key":"e_1_2_1_8_2","first-page":"8","article-title":"Clinical application of the tension\u2010stress effect for limb lengthening","volume":"247","author":"Ilizarov GA","year":"1990","journal-title":"Clinical Orthopaedics and Related Research"},{"key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/00003086-199001000-00005","article-title":"Bone regenerate formation in cortical bone during distraction lengthening: An experimental study","volume":"250","author":"Delloye Ch","year":"1990","journal-title":"Clinical Orthopaedics and Related Research"},{"key":"e_1_2_1_10_2","first-page":"601","article-title":"Extremit\u00e4ten\u2010Verl\u00e4ngerung und die Behandlung von Segment\u2010Defekten durch Callus\u2010Distraktion","volume":"58","author":"Giebel G","year":"1990","journal-title":"Chirurgie"},{"key":"e_1_2_1_11_2","first-page":"357","article-title":"Die Behandlung ausgedehnter Knochendefekte am Unterschenkel durch Verschiebeosteotomie nach Ilizarow","volume":"59","author":"R\u00fcter A","year":"1988","journal-title":"Chirurgie"},{"key":"e_1_2_1_12_2","volume-title":"Transosseous Osteosynthesis\u2014Theoretical and Clinical Aspects of the Regeneration and Growth of Tissue","author":"Ilizarov GA","year":"1991"},{"key":"e_1_2_1_13_2","first-page":"605","article-title":"Erstes voll implantierbares intramedull\u00e4res System zur Callusdistraktion\u2014Marknagel mit programmierbarem Antrieb zur Beinl\u00e4ngenverl\u00e4ngerung und Segmentverschiebung","volume":"61","author":"Betz A","year":"1990","journal-title":"Chirurgie"},{"key":"e_1_2_1_14_2","unstructured":"BetzA BaumgartR HiernerR SeiboldR SchweibererL:Der programmierbare Marknegal zur Extremit\u00e4tenverl\u00e4ngerung und Segmentverschiebung mittels Kallusdistraktion Hefte zur Unfallheilkunde(in press)."},{"key":"e_1_2_1_15_2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/00003086-199001000-00011","article-title":"Problems, obstacles and complications of limb lengthening by the Ilizarow technique","volume":"250","author":"Paley D","year":"1990","journal-title":"Clinical Orthopaedics and Related Research"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0363-5023(90)90014-I"},{"key":"e_1_2_1_17_2","first-page":"67","volume-title":"Microsurgery for Major Limb Reconstruction","author":"Chen Zhong\u2010Wei","year":"1987"},{"key":"e_1_2_1_18_2","unstructured":"AllieuY D'AnjouB VannerauH QuaknineR CenecP:L'expansion nerveuse. Abstract symposium Actualit\u00e9s en Chirurgie des nerfs p\u00e9riph\u00e9riques du laboratoire aux applications cliniques Nancy France 8th\u20109th November1990."},{"key":"e_1_2_1_19_2","first-page":"121","article-title":"Peripheral nerve damage during limb lengthening","volume":"72","author":"Galardi G","year":"1991","journal-title":"Journal of Bone and Joint Surgery"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmicr.1920140706","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.1920140706","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T06:04:47Z","timestamp":1698300287000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.1920140706"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,1]]},"references-count":18,"journal-issue":{"issue":"7","published-print":{"date-parts":[[1993,1]]}},"alternative-id":["10.1002\/micr.1920140706"],"URL":"https:\/\/doi.org\/10.1002\/micr.1920140706","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,1]]}}}