sixth editiion

SIXTH EDITIION

Section Editors

SPINEThemistocles Protopsaltis, MDChief, Division of Spine SurgeryDepartment of Orthopedic SurgeryNYU Langone HealthNYU Langone Orthopedic HospitalNew York, New York

HANDNader Paksima, DO, MPHChief of Orthopedic SurgeryJamaica Hospital Medical CenterClinical Professor Orthopedic SurgeryAssociate Chief of Hand ServiceNYU Langone HealthNYU Langone Orthopedic HospitalNew York, New York

PEDIATRICSPablo Castañeda, MDThe Elly and Steven Hammerman Professor of Pediatric Orthopaedic SurgeryDepartment of Orthopedic SurgeryChief, Division of Pediatric Orthopaedic SurgeryHassenfeld Children’s Hospital at NYU LangoneNYU Langone HealthNYU Langone Orthopedic HospitalNew York, New York

Contributing AuthorANESTHESIAUchenna O. Umeh, MDAssistant Professor of AnesthesiologyAssociate Regional Fellowship DirectorDepartment of Anesthesiology, Perioperative Care and Pain MedicineNYU Langone HealthNYU Langone Orthopedic HospitalNew York, New York

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6th edition

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Copyright © 2015 Wolters Kluwer Health. Copyright © 2002, 2006, and 2010 Lippincott Williams & Wilkins. All rightsreserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or byany means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage andretrieval system without written permission from the copyright owner, except for brief quotations embodied in criticalarticles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S.government employees are not covered by the above-mentioned copyright. To request permission, please contact WoltersKluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], orvia our web site at shop.lww.com (products and services).

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To my family, Lori, Alexander, Jonathan, and Gabrielle, and to my mentors, KJK, JDZ, andMJB.

— KENNETH A. EGOL

To my children who are constants in my life and have always been there for me. Thank youCourtney, Michael, and Lauren. And to my parents who provided me guidance and inspiration

throughout my life.

— KENNETH J. KOVAL

To the residents and faculty of the NYU Langone Health Department of Orthopedic Surgery forall of their support during the past 30 years and to Ken Egol who has brought this book to new

levels of excellence.

— JOSEPH D. ZUCKERMAN

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Contents

Preface

Part One: GENERAL CONSIDERATIONS

1. Closed Reduction, Casting, and TractionPRINCIPLES OF CLOSED REDUCTIONCOMMON SPLINTING TECHNIQUESCASTING

BELOW-KNEE (SHORT LEG) CASTABOVE-KNEE (LONG LEG) CASTSHORT AND LONG ARM CASTS

COMPLICATIONS OF CASTS AND SPLINTSPOSITIONS OF FUNCTIONTRACTION

SKIN TRACTION (BUCK)SKELETAL TRACTION

Tibial Skeletal TractionFemoral Skeletal TractionCalcaneal Skeletal TractionOlecranon TractionGardner-Wells TongsHaloSpanning External Fixation

2. Multiple TraumaFIELD TRIAGE

MANAGEMENT PRIORITIESTRAUMA DEATHSGOLDEN HOURTHE TEAMRESUSCITATIONAIRWAY CONTROLBREATHINGCIRCULATIONINITIAL MANAGEMENT OF THE PATIENT IN SHOCKDIFFERENTIAL DIAGNOSIS OF HYPOTENSION IN TRAUMA

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CARDIOGENIC SHOCKNEUROGENIC SHOCKSEPTIC SHOCKHEMORRHAGIC SHOCK

CLASSIFICATION OF HEMORRHAGEBLOOD REPLACEMENTPNEUMATIC ANTISHOCK GARMENT OR MILITARY ANTISHOCK TROUSERS(USED IN FIELD ONLY)INDICATIONS FOR IMMEDIATE SURGERYDISABILITY (NEUROLOGIC ASSESSMENT)INJURY SEVERITY SCOREEXPOSURERADIOGRAPHIC EVALUATIONSTABILIZATIONDECISION TO OPERATECONCOMITANT INJURIES

HEAD INJURIESEvaluation

THORACIC INJURIESEvaluation

ABDOMINAL INJURIESEvaluation

GENITOURINARY INJURIESEvaluation

COMPARTMENT SYNDROMEEvaluation

FAT EMBOLISM SYNDROMEEvaluation

3. Open FracturesMECHANISM OF INJURYCLINICAL EVALUATIONCOMPARTMENT SYNDROMEVASCULAR INJURYRADIOGRAPHIC EVALUATIONCLASSIFICATION

GUSTILO AND ANDERSON (OPEN FRACTURES)TSCHERNE CLASSIFICATION OF OPEN FRACTURESTSCHERNE CLASSIFICATION OF CLOSED FRACTURES

TREATMENTEMERGENCY ROOM MANAGEMENT

ImportantAntibiotic Coverage for Open Fractures

OPERATIVE TREATMENTIrrigation and DebridementForeign BodiesFracture Stabilization

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Soft Tissue Coverage and Bone GraftingLimb Salvage

COMPLICATIONS 4. Gunshot Wounds

BALLISTICSENERGYTISSUE PARAMETERSCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONTREATMENT OF ORTHOPAEDIC GUNSHOT INJURIES

LOW-VELOCITY WOUNDSHIGH-VELOCITY AND SHOTGUN WOUNDS

COMPLICATIONS 5. Pathologic Fractures

DEFINITIONMECHANISM OF INJURYCLINICAL EVALUATIONLABORATORY EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

SPRINGFIELDSystemicLocalized

CLASSIFICATION BY PATHOLOGIC PROCESSSystemic Skeletal DiseaseLocal DiseaseMiscellaneous

TREATMENTINITIAL TREATMENTNONOPERATIVE TREATMENTOPERATIVE TREATMENTADJUVANT THERAPY: RADIATION THERAPY AND CHEMOTHERAPYMETASTASES OF UNKNOWN ORIGINMANAGEMENT OF SPECIFIC PATHOLOGIC FRACTURES

Femur FracturesHumerus FracturesSpine Fractures

6. Periprosthetic FracturesTOTAL HIP ARTHROPLASTY

FEMORAL SHAFT FRACTURESEpidemiologyRisk FactorsSurgical Considerations (to Avoid Periprosthetic Fracture during Revision Surgery)ClassificationTreatment Principles

ACETABULAR FRACTURES

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TOTAL KNEE ARTHROPLASTYSUPRACONDYLAR FEMUR FRACTURES

EpidemiologyRisk FactorsClassificationTreatment

TIBIAL FRACTURESRisk FactorsClassificationTreatment

PATELLA FRACTURESEpidemiologyRisk FactorsClassificationTreatment

TOTAL SHOULDER ARTHROPLASTYEPIDEMIOLOGYRISK FACTORSCLASSIFICATION

University of Texas San Antonio Classification of Periprosthetic ShoulderFractures

TREATMENTNonoperative TreatmentOperative Treatment

TOTAL ELBOW ARTHROPLASTYEPIDEMIOLOGYRISK FACTORSCLASSIFICATIONTREATMENT

Nonoperative TreatmentOperative Treatment

7. Orthopaedic AnalgesiaPHARMACOLOGY: CLASSES OF DRUGSLOCAL ANESTHETICSVASOCONSTRICTORSOPIOIDSSEDATIVESNITROUS OXIDEREGIONAL BLOCKS AND CONSCIOUS SEDATION

HEMATOMA BLOCKREGIONAL BLOCKS

Digital BlockWrist BlockElbow BlockAxillary BlockAnkle Block

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Popliteal BlockBier Block

MODERATE SEDATION

Part Two: AXIAL SKELETON FRACTURES

8. General SpineEPIDEMIOLOGYANATOMYMECHANISM OF INJURY

PRIMARY INJURYSECONDARY INJURY

CLINICAL EVALUATIONSPINAL SHOCKNEUROGENIC SHOCKBULBOCAVERNOSUS REFLEX

RADIOGRAPHIC EVALUATIONCLASSIFICATIONGRADING OF NEUROLOGIC INJURY

SPINAL CORD INJURY: COMPLETESPINAL CORD INJURY: INCOMPLETE

PATTERNS OF INCOMPLETE SPINAL CORD INJURYBROWN-SÉQUARD SYNDROMECENTRAL CORD SYNDROMEANTERIOR CORD SYNDROMEPOSTERIOR CORD SYNDROMECONUS MEDULLARIS SYNDROME

NERVE ROOT LESIONSCAUDA EQUINA SYNDROMEGRADING SYSTEMS FOR SPINAL CORD INJURY

FRANKEL CLASSIFICATIONAMERICAN SPINAL INJURY ASSOCIATION IMPAIRMENT SCALEAMERICAN SPINAL INJURY ASSOCIATION NEUROLOGIC ASSESSMENT

TREATMENTIMMOBILIZATIONMEDICAL MANAGEMENT OF ACUTE SPINAL CORD INJURY

COMPLICATIONSCLEARING THE SPINE

SURGICAL MANAGEMENT OF ACUTE SPINAL CORD INJURY 9. Cervical Spine

EPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

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ORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF CERVICALSPINE INJURIES

INJURIES TO THE OCCIPUT–C1–C2 COMPLEXOCCIPITAL CONDYLE FRACTURES

CLASSIFICATIONOCCIPITOATLANTAL DISLOCATION (CRANIOVERTEBRAL DISSOCIATION)ATLAS FRACTURESTRANSVERSE LIGAMENT RUPTURE (TRAUMATIC C1–C2 INSTABILITY)ATLANTOAXIAL ROTARY SUBLUXATION AND DISLOCATIONFRACTURES OF THE ODONTOID PROCESS (DENS)C2 LATERAL MASS FRACTURESTRAUMATIC SPONDYLOLISTHESIS OF C2 (HANGMAN’S FRACTURE)

INJURIES TO C3–C7CLASSIFICATION (ALLEN-FERGUSON)

TREATMENT: GENERAL CERVICAL SPINEINITIAL TREATMENTSTABILIZATION OF THE UPPER CERVICAL SPINE (OCCIPUT–C2)

Anterior ApproachPosterior ApproachOsteosynthesis

STABILIZATION OF THE LOWER CERVICAL SPINE (C3–C7)COMPLICATIONS

10. Thoracolumbar SpineEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

ORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF THORACICAND LUMBAR SPINE INJURIESMCAFEE ET AL.MCCORMACK ET AL.THORACOLUMBAR INJURY CLASSIFICATION SYSTEM

SPINAL STABILITYWHITE AND PUNJABIDENISMcAFEEAOSPINE THORACOLUMBAR CLASSIFICATION

Fracture MorphologyGUNSHOT WOUNDSPROGNOSIS AND NEUROLOGIC RECOVERY

BRADFORD AND McBRIDEDALL AND STAUFFERCAMISSA ET AL.KEENEN ET AL.

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COMPLICATIONS

Part Three: UPPER EXTREMITY FRACTURES AND DISLOCATIONS

11. Clavicle FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONASSOCIATED INJURIESRADIOGRAPHIC EVALUATIONCLASSIFICATION

DESCRIPTIVEALLMANORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF CLAVICLEFRACTURES

TREATMENTNONOPERATIVEOPERATIVE

COMPLICATIONS12. Acromioclavicular and Sternoclavicular Joint Injuries

ACROMIOCLAVICULAR JOINT INJURYEPIDEMIOLOGYANATOMYMECHANISM OF INJURYASSOCIATED FRACTURES AND INJURIESCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATIONTREATMENTCOMPLICATIONS

STERNOCLAVICULAR JOINT INJURYEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

AnatomicEtiologic

TREATMENTCOMPLICATIONS

13. Scapula and Thorax FracturesSCAPULA FRACTURES

EPIDEMIOLOGYANATOMY

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MECHANISM OF INJURYASSOCIATED INJURIESCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

Anatomic Classification: Zdravkovic and DamholtIdeberg Classification of Intra-articular Glenoid FracturesClassification of Acromial FracturesClassification of Coracoid FracturesOrthopaedic Trauma Association Classification of Scapula Fractures

TREATMENTNonoperativeOperativeSurgical considerations

COMPLICATIONSScapulothoracic DissociationIntrathoracic Dislocation of the Scapula

RIB FRACTURESEPIDEMIOLOGYANATOMYMECHANISM OF INJURYASSOCIATED INJURIESCLINICAL EVALUATIONRADIOLOGIC EVALUATIONCLASSIFICATION

DescriptiveOrthopaedic Trauma Association Classification

TREATMENTNonoperativeOperative

COMPLICATIONS14. Glenohumeral Dislocation

EPIDEMIOLOGYANATOMYANTERIOR GLENOHUMERAL DISLOCATION

INCIDENCEMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATIONTREATMENT

NonoperativeOperative

COMPLICATIONSPOSTERIOR GLENOHUMERAL DISLOCATION

INCIDENCE

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MECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

Etiologic ClassificationAnatomic Classification


COMPLICATIONSINFERIOR GLENOHUMERAL DISLOCATION (LUXATIO ERECTA)

MECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONTREATMENT


COMPLICATIONSSUPERIOR GLENOHUMERAL DISLOCATION

MECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONTREATMENTCOMPLICATIONS

15. Proximal Humerus FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

NEERORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF PROXIMALHUMERUS FRACTURES

TREATMENTSURGICAL CONSIDERATIONS

COMPLICATIONS16. Humeral Shaft Fractures


DESCRIPTIVEORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION

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TREATMENTNONOPERATIVEOPERATIVEPATIENT POSITIONINGIMAGE POSITIONING

Surgical TechniquesIntramedullary FixationPostoperative Rehabilitation

COMPLICATIONS17. Distal Humerus


DESCRIPTIVEORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF FRACTURESOF THE DISTAL HUMERUS

GENERAL TREATMENT PRINCIPLESSPECIFIC FRACTURE TYPES

EXTRA-ARTICULAR SUPRACONDYLAR FRACTURETreatmentComplications

TRANSCONDYLAR FRACTURESMechanism of InjuryTreatment

INTERCONDYLAR FRACTURESMechanism of InjuryClassificationTreatmentComplicationsMechanism of InjuryClassificationTreatmentComplications

CAPITELLUM FRACTURESMechanism of InjuryClassificationTreatmentComplications

TROCHLEA FRACTURES (LAUGIER FRACTURE)Mechanism of InjuryTreatmentComplications

LATERAL EPICONDYLAR FRACTURES

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Mechanism of InjuryTreatmentComplications

MEDIAL EPICONDYLAR FRACTURESMechanism of InjuryTreatmentComplications

FRACTURES OF THE SUPRACONDYLAR PROCESSMechanism of InjuryTreatmentComplications

18. Elbow DislocationEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONASSOCIATED INJURIESRADIOGRAPHIC EVALUATIONCLASSIFICATION

FRACTURE-DISLOCATIONSTYPES OF ELBOW INSTABILITY

Posterolateral Rotatory InstabilityVarus, Posteromedial Rotational InstabilityTransolecranon Fracture-Dislocations (Anterior)Instability Scale (Morrey)

GENERAL TREATMENT PRINCIPLESSIMPLE ELBOW DISLOCATION


ELBOW FRACTURE-DISLOCATIONS IN GENERALNonoperativeOperative

“TERRIBLE TRIAD” FRACTURE-DISLOCATIONSCOMPLICATIONS

19. OlecranonEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

MAYO CLASSIFICATIONSCHATZKER: BASED ON FRACTURE PATTERNORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF PROXIMALRADIUS/ULNA FRACTURES

TREATMENT

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OBJECTIVESNONOPERATIVEOPERATIVE

COMPLICATIONS20. Radial Head


MASONORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF PROXIMALRADIUS/ULNA FRACTURES

TREATMENT GOALSTREATMENT

NONOPERATIVEOPERATIVE

OPEN REDUCTION AND INTERNAL FIXATIONIsolated Partial Radial Head FracturesPartial Radial Head Fracture as Part of a Complex InjuryFractures Involving the Entire Head of the RadiusProsthetic ReplacementRadial Head ExcisionEssex-Lopresti LesionPostoperative Care

COMPLICATIONS21. Radius and Ulna Shaft Fractures

EPIDEMIOLOGYANATOMYFRACTURES OF BOTH THE RADIUS AND ULNA SHAFTS


DescriptiveOrthopaedic Trauma Association Classification ofFractures of the Radial and Ulna Shaft


COMPLICATIONSRISK FACTORS

FRACTURES OF THE ULNA SHAFTMECHANISM OF INJURYCLINICAL EVALUATION

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RADIOGRAPHIC EVALUATIONCLASSIFICATION OF ULNA FRACTURES

DescriptiveBado Classification of Monteggia Fractures

CLASSIFICATIONOrthopaedic Trauma Association Classification of Fractures of the Ulna Shaft

TREATMENTNightstick FracturesMonteggia Fractures

COMPLICATIONSFRACTURES OF THE RADIAL SHAFT


Orthopaedic Trauma Association Classification of Fractures of the Radial ShaftTREATMENT

Proximal Radius FractureGaleazzi Fractures

COMPLICATIONS22. Distal Radius Fractures


DESCRIPTIVEFRYKMAN CLASSIFICATION OF COLLES FRACTURESFERNANDEZ CLASSIFICATIONORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF FRACTURESOF THE DISTAL RADIUS AND ULNAEPONYMS


Operative TechniquesCOMPLICATIONS

23. Wrist FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

ORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF CARPAL

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FRACTURES AND FRACTURE-DISLOCATIONSSPECIFIC FRACTURES

SCAPHOIDTreatment

PROXIMAL FRACTURES (PRONE TO NONUNION AND OSTEONECROSIS)LUNATETRIQUETRUMPISIFORMTRAPEZIUMTRAPEZOIDCAPITATEHAMATE

PERILUNATE DISLOCATIONS AND FRACTURE-DISLOCATIONSSCAPHOLUNATE DISSOCIATIONLUNOTRIQUETRAL DISSOCIATIONULNOCARPAL DISSOCIATION

24. Fractures and Dislocations of the HandEPIDEMIOLOGYANATOMY

METACARPALSPHALANGES


DESCRIPTIVEOPEN FRACTURES

Swanson, Szabo, and AndersonOrthopaedic Trauma Association Classification ofMetacarpal and Phalangeal Fractures

GENERAL TREATMENT PRINCIPLESMANAGEMENT OF SPECIFIC FRACTURE PATTERNS

METACARPALSMetacarpal HeadMetacarpal NeckMetacarpal ShaftMetacarpal Base

PROXIMAL AND MIDDLE PHALANGESIntra-articular FracturesProximal Interphalangeal Fracture-DislocationsExtra-articular Fractures

DISTAL PHALANXIntra-articular FracturesExtra-articular Fractures

NAIL BED INJURIESMETACARPOPHALANGEAL JOINT DISLOCATIONS

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THUMB METACARPOPHALANGEAL JOINT DISLOCATIONSPROXIMAL INTERPHALANGEAL JOINT DISLOCATIONSDISTAL INTERPHALANGEAL AND THUMB INTERPHALANGEAL JOINTDISLOCATIONS

Nonoperative TreatmentOperative Treatment

COMPLICATIONS

Part Four: LOWER EXTREMITY FRACTURES AND DISLOCATIONS

25. Pelvis FracturesEPIDEMIOLOGYANATOMYPELVIC STABILITYMECHANISM OF INJURYCLINICAL EVALUATIONHEMODYNAMIC STATUSNEUROLOGIC INJURYGENITOURINARY AND GASTROINTESTINAL INJURY

BOWEL INJURYRADIOGRAPHIC EVALUATIONCLASSIFICATION

YOUNG AND BURGESSORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF PELVICFRACTURES

FACTORS INCREASING MORTALITYASSOCIATED MOREL-LAVALLÉE LESION (SKIN DEGLOVING INJURY)

TREATMENTNONOPERATIVE

Absolute Indications for Operative TreatmentRelative Indications for Operative Treatment

OPERATIVE TECHNIQUESSPECIAL CONSIDERATIONS

COMPLICATIONS26. Acetabulum Fractures


JUDET-LETOURNELElementary FracturesAssociated Fractures

TREATMENTINITIAL MANAGEMENT

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NONOPERATIVEOPERATIVE

StabilityCongruitySurgical ApproachesPostoperative Care

COMPLICATIONS27. Hip Dislocations

EPIDEMIOLOGYANATOMYMECHANISM OF INJURY

ANTERIOR DISLOCATIONSPOSTERIOR DISLOCATIONS

CLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

THOMPSON AND EPSTEIN CLASSIFICATION OF POSTERIOR HIPDISLOCATIONSEPSTEIN CLASSIFICATION OF ANTERIOR HIP DISLOCATIONSORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF HIPDISLOCATIONS

TREATMENTCLOSED REDUCTIONOPEN REDUCTION

PROGNOSISCOMPLICATIONS

28. Femoral Head FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

PIPKINORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF FEMORALHEAD FRACTURES

TREATMENTPIPKIN TYPE IPIPKIN TYPE IIPIPKIN TYPE IIIPIPKIN TYPE IVFEMORAL HEAD FRACTURES ASSOCIATED WITH ANTERIORDISLOCATIONS

COMPLICATIONS29. Femoral Neck Fractures

EPIDEMIOLOGY

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ANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

ANATOMIC LOCATIONPAUWELGARDENORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF FEMORALNECK FRACTURES

TREATMENTFATIGUE/STRESS FRACTURESIMPACTED/NONDISPLACED FRACTURESDISPLACED FRACTURESOPERATIVE TREATMENT PRINCIPLES

COMPLICATIONS30. Intertrochanteric Fractures


EVANSORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OFINTERTROCHANTERIC FRACTURES

UNUSUAL FRACTURE PATTERNSBASICERVICAL FRACTURESREVERSE OBLIQUE FRACTURES


Timing of SurgeryFixation ImplantsProsthetic ReplacementExternal FixationSpecial ConsiderationsRehabilitation

COMPLICATIONSGREATER TROCHANTERIC FRACTURESLESSER TROCHANTERIC FRACTURES

31. Subtrochanteric FracturesEPIDEMIOLOGYANATOMY

MECHANISM OF INJURYCLINICAL EVALUATION

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RADIOGRAPHIC EVALUATIONCLASSIFICATION

RUSSELL-TAYLOR (HISTORICAL)ORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OFSUBTROCHANTERIC FRACTURES

TREATMENTNONOPERATIVE (HISTORICAL)OPERATIVE

ImplantsBone GraftingOpen Subtrochanteric Fractures

COMPLICATIONSLOSS OF FIXATIONNONUNIONMALUNION

32. Femoral Shaft FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONASSOCIATED INJURIESRADIOGRAPHIC EVALUATIONCLASSIFICATION

DESCRIPTIVEWINQUIST AND HANSENORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF FEMORALSHAFT FRACTURES


Skeletal TractionOPERATIVEINTRAMEDULLARY NAILING

Antegrade Inserted Intramedullary NailingRetrograde Inserted Intramedullary NailingExternal FixationPlate FixationFemur Fracture in Multiply Injured PatientIpsilateral Fractures of the Proximal or Distal FemurOpen Femoral Shaft Fractures

REHABILITATIONCOMPLICATIONS

33. Distal Femur FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATION

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RADIOGRAPHIC EVALUATIONCLASSIFICATION

DESCRIPTIVENEERORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF DISTALFEMORAL FRACTURES


ImplantsAssociated Vascular InjurySupracondylar Fractures Above a Total Knee ReplacementPostoperative Management

COMPLICATIONS34. Knee Dislocation (Femorotibial)


MODIFIED SCHENCKDESCRIPTIVE

Utility of Anatomic ClassificationTREATMENT

GENERAL TREATMENT CONSIDERATIONSNONOPERATIVEOPERATIVE

Treatment Recommendations of Specific PatternsCOMPLICATIONS

35. Patella and Extensor Mechanism InjuriesPATELLAR FRACTURES


DescriptiveOrthopaedic Trauma Association Classification of Patellar Fractures


COMPLICATIONSPATELLA DISLOCATION

EPIDEMIOLOGY

26

ANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATIONTREATMENT


COMPLICATIONSQUADRICEPS TENDON RUPTURE

EPIDEMIOLOGYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONTREATMENT


POSTOPERATIVE MANAGEMENTCOMPLICATIONS

PATELLA TENDON RUPTUREEPIDEMIOLOGYANATOMYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATIONTREATMENT


COMPLICATIONS36. Tibial Plateau Fractures

EPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONASSOCIATED INJURIESRADIOGRAPHIC EVALUATIONCLASSIFICATION

SCHATZKERHOHL AND MOOREORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF TIBIALPLATEAU FRACTURES (TYPE 43)


COMPLICATIONS37. Tibia and Fibula Shaft Fractures

EPIDEMIOLOGY

27

ANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

DESCRIPTIVEORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF TIBIALFRACTURESGUSTILO AND ANDERSON CLASSIFICATION OF OPEN FRACTURES (FINALGRADING DONE AFTER DEBRIDEMENT)TSCHERNE CLASSIFICATION OF CLOSED FRACTURES


Acceptable Fracture ReductionTime to UnionTibia Stress FractureFibula Shaft Fracture

OPERATIVEIntramedullary NailingFlexible Nails (Enders, Rush Rods)External FixationPlates and ScrewsProximal Tibia FracturesDistal Tibia FracturesTibia Fracture with an Intact FibulaFasciotomy

COMPLICATIONS38. Injuries about the Ankle

ROTATIONAL ANKLE FRACTURESEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

Lauge-Hansen (Rotational Ankle Fractures)Orthopaedic Trauma Association Classification of Ankle FracturesFracture Variants

TREATMENTAcute Care (Emergency Department)NonoperativeOperative

COMPLICATIONSPLAFOND (PILON) FRACTURES

EpidemiologyMechanism of Injury

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Clinical EvaluationRadiographic EvaluationClassificationOrthopaedic Trauma Association Classification of Distal Tibia FracturesTreatmentComplications

LATERAL ANKLE LIGAMENT INJURIESMechanism of InjuryClassificationClinical EvaluationRadiographic EvaluationTreatment

SYNDESMOSIS SPRAINSClassificationClinical EvaluationRadiographic EvaluationTreatment

ACHILLES TENDON RUPTUREEpidemiologyAnatomyClinical EvaluationTreatment

PERONEAL TENDON SUBLUXATIONClinical EvaluationTreatment

39. Calcaneus FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATION

ASSOCIATED INJURIESRADIOGRAPHIC EVALUATIONCLASSIFICATION

EXTRA-ARTICULAR FRACTURESINTRA-ARTICULAR FRACTURES

Essex-Lopresti ClassificationSanders Classification

ORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF CALCANEALFRACTURES

TREATMENTNONOPERATIVEOPERATIVESPECIFIC FRACTURES

Extra-articular FracturesIntra-articular Fractures

COMPLICATION

29

40. Talus FracturesEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

ANATOMICHAWKINS CLASSIFICATION OF TALAR NECK FRACTURESORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF TALARFRACTURES

TREATMENTFRACTURES OF THE TALAR NECK AND BODY

Nondisplaced Fractures (Hawkins Type I)Displaced Fractures (Hawkins Types II to IV)

TALAR BODY FRACTURESCLASSIFICATIONTREATMENTLATERAL PROCESS FRACTURESPOSTERIOR PROCESS FRACTURESTALAR HEAD FRACTURES

COMPLICATIONSSUBTALAR DISLOCATIONTOTAL DISLOCATION OF THE TALUS

41. Fractures of the Midfoot and ForefootMIDTARSAL (CHOPART) JOINT


Medial Stress InjuryLongitudinal Stress InjuryLateral Stress InjuryPlantar Stress Injury


COMPLICATIONSTARSAL NAVICULAR

EPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATION

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CLASSIFICATIONOrthopaedic Trauma Association Classification of Navicular FracturesAnatomic Classification


COMPLICATIONSNAVICULAR DISLOCATIONCUBOID FRACTURES


Orthopaedic Trauma Association ClassificationTREATMENT


COMPLICATIONSCUNEIFORM FRACTURES

ORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF CUNEIFORMFRACTURES

TARSOMETATARSAL (LISFRANC) JOINTEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONASSOCIATED INJURIESCLASSIFICATION

Quenu and KussMyerson

TREATMENTNonoperativeOperativePostoperative Management

COMPLICATIONSFRACTURES OF THE FOREFOOT

METATARSALSEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationClassification

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Specific Metatarsal InjuriesMETATARSOPHALANGEAL JOINTS

First Metatarsophalangeal JointFRACTURES AND DISLOCATIONS OF THE LESSERMETATARSOPHALANGEAL JOINTS

EpidemiologyAnatomyMechanism of InjuryClinical EvaluationClassificationTreatmentComplications

SESAMOIDSEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationClassificationTreatmentComplications

PHALANGES AND INTERPHALANGEAL JOINTSEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationClassificationTreatmentComplicationsDislocation of the Interphalangeal Joint

Part Five: PEDIATRIC FRACTURES AND DISLOCATIONS

42. Pediatric Orthopaedic Surgery: General PrinciplesOVERVIEWEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

SALTER-HARRIS AND PETERSONTREATMENTCOMPLICATIONS

43. Pediatric Shoulder

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PROXIMAL HUMERUS FRACTURESEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

Salter-HarrisNeer-Horowitz Classification of Proximal Humeral Plate Fractures

TREATMENTNewbornsAge 1 to 4 YearsAge 5 to 12 YearsAge 12 Years to MaturityAcceptable DeformityOpen Treatment

PROGNOSISCOMPLICATIONS

CLAVICLE FRACTURESEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

DescriptiveAllman

TREATMENTNewborn to 2 YearsAge 2 to 12 YearsAge 12 Years to MaturityOpen Treatment

COMPLICATIONSACROMIOCLAVICULAR JOINT INJURIES

EPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION (DAMERON AND ROCKWOOD)TREATMENTCOMPLICATIONS

SCAPULA FRACTURESEPIDEMIOLOGYANATOMYMECHANISM OF INJURY

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CLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONCLASSIFICATION

Classification by LocationTREATMENTCOMPLICATIONS

GLENOHUMERAL DISLOCATIONSEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATION

Anterior DislocationPosterior DislocationAtraumatic DislocationSuperior and Inferior (Luxatio Erecta) Dislocation

RADIOGRAPHIC EVALUATIONCLASSIFICATIONTREATMENTCOMPLICATIONS

44. Pediatric ElbowEPIDEMIOLOGYANATOMYMECHANISM OF INJURYCLINICAL EVALUATIONRADIOGRAPHIC EVALUATIONSPECIFIC FRACTURES

SUPRACONDYLAR HUMERUS FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical EvaluationClassificationTreatmentComplications

LATERAL CONDYLAR PHYSEAL FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationTreatment

MEDIAL CONDYLAR PHYSEAL FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical Evaluation

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Radiographic EvaluationClassificationTreatmentComplications

TRANSPHYSEAL FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationClassificationTreatmentComplications

MEDIAL EPICONDYLAR APOPHYSEAL FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationClassificationTreatmentComplications

LATERAL EPICONDYLAR APOPHYSEAL FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationClassificationTreatmentComplications

CAPITELLUM FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic EvaluationClassificationTreatmentComplications

T-CONDYLAR FRACTURESEpidemiologyAnatomyMechanism of InjuryClinical EvaluationRadiographic Evaluation

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sixth editiion

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