From plastic surgery residency and orthopedic hand surgery fellowship, I evaluate patients with an ortho-plastic approach that combines the knowledge of musculoskeletal derangement and their fixation with soft tissue principles, wound care, and microsurgical reconstruction. The Limb Restoration Clinic at Philadelphia Hand to Shoulder Center was created to address the most complex problems of nerve. It offers all the traditional as well as cutting-edge techniques of tendon transfer, nerve transfer, microsurgical free tissue transfer (“free flap”), nerve reconstruction, targeted muscle reinnervation (TMR), etc. for brachial plexus injury, neuroma, spinal cord injury, mangled extremity, and limb loss patients. A team of surgeons, therapists, prosthetists, and mental health professionals evaluates each patient to optimize outcomes.