In early treatment results of reconstructive microsurgery could be improved dramatically within the last 20 years. International results show a clear advantage for patients, who are operated within the first months after injury. In consequence our aim is to examine and treat these injuries as early as possible. The unit at the ukb has a clear algorithm for diagnostic and treatment as a base for daily work. The surgery includes direct repair, nerve transplants and transfers, free neurovascular muscle transplants and late reconstruction including muscle transfers.