Skeletal Trauma

1. Introduction - p. 1 2. 1 The History of Trauma Care - p. 2 3. 2 Global Burden of Musculoskeletal Injuries - p. 25 4. 3 The Challenges of Orthopaedic Trauma Care in the Developing World - p. 33 5. 4 Vascularity and Stability - p. 69 6. 5 Biology and Enhancement of Skeletal Repair - p. 79 7. Introduction - p. 79 8. Biology of Graft Substitutes - p. 79 9. Autogenous Iliac Crest Bone Graft - p. 85 10. Osteoconductive Graft Substitutes - p. 87 11. Demineralized Bone Matrix - p. 96 12. Patient-Derived Cellular Therapies - p. 100 13. Inductive Substrates (Bone Morphogenetic Proteins) - p. 112 14. Conclusion - p. 119 15. References - p. 120 16. 6 Biomechanics of Fractures - p. 129 17. 7 Closed Fracture Management - p. 160 18. 8 Principles and Complications of External Skeletal Fixation - p. 207 19. 9 Principles of Internal Fixation - p. 256 20. Introduction - p. 256 21. Plan of Attack and How to Use This Chapter - p. 256 22. Fracture Pattern - p. 257 23. Soft Tissue Pattern - p. 260 24. Area Involved - p. 265 25. Desired Stability - p. 267 26. Approach - p. 280 27. Reduction: Direct Versus Indirect - p. 285 28. Fixation - p. 293 29. Steps of Intramedullary Rodding - p. 321 30. Construct Stability - p. 326 31. Construct Failure - p. 331 32. Preoperative Planning - p. 334 33. Summary - p. 336 34. References - p. 336 35. 10 Evaluation and Treatment of the Multi-Injured Trauma Patient - p. 339 36. 11 Initial Evaluation of the Spine in Trauma Patients - p. 356 37. 12 Damage Control Orthopaedic Surgery: A Strategy for the Orthopaedic Care of the Critically Injured Patient - p. 373 38. 13 Disaster Management - p. 394 39. 14 The Management of Acute and Perioperative Pain Associated With Trauma and Surgery - p. 417 40. Introduction - p. 417 41. Physiology of Pain - p. 419 42. Assessment of Acute Pain - p. 423 43. Treatment of Acute Pain - p. 425 44. Controversial Issues in Acute Pain Medicine - p. 446 45. Some Practical Considerations for Collaboration Between Orthopaedic Surgeons and Acute and Chronic Pain Specialists - p. 450 46. Conclusion - p. 451 47. Acknowledgments - p. 451 48. References - p. 451 49. 15 Chronic Pain Management - p. 458 50. 16 Evaluation and Treatment of Vascular Injuries - p. 474 51. 17 Compartment Syndromes - p. 499 52. 18 Open Fractures - p. 530 53. 19 Soft Tissue Reconstruction - p. 561 54. 20 Gunshot Wounds and Blast Injuries - p. 585 55. 21 Pathologic Fractures - p. 613 56. 22 Osteoporotic Fragility Fractures - p. 647 57. 23 Surgical Site Infection Prevention - p. 660 58. 24 Diagnosis and Treatment of Complications - p. 676 59. 25 Understanding and Treating Chronic Osteomyelitis - p. 707 60. 26 Nonunions - p. 743 61. Introduction - p. 743 62. Definitions - p. 743 63. Fracture Repair - p. 743 64. Etiology of Nonunions - p. 744 65. Evaluation of Nonunions - p. 747 66. Treatment - p. 762 67. Summary - p. 826 68. Acknowledgments - p. 826 69. References - p. 827 70. 27 Motorized Intramedullary Lengthening Nail for Limb Reconstruction - p. 835 71. 28 Psychological, Social, and Functional Manifestations of Orthopaedic Trauma and Traumatic Brain Injury* - p. 853 72. Section Two Spine - p. 873 73. Introduction - p. 875 74. 29 Pathophysiology and Early Management of Spinal Cord Injury - p. 876 75. 30 Craniocervical Injuries - p. 886 76. 31 Craniocervical Injuries - p. 916 77. 32 Subaxial Cervical Spine Trauma - p. 948 78. 33 Thoracolumbar Trauma - p. 988 79. Classification - p. 988 80. Treatment of Burst Fractures - p. 995 81. Flexion-Distraction and Fracture-Dislocation Injuries - p. 1009 82. Low-Lumbar Fractures - p. 1021 83. New Concepts in Management of Thoracolumbar Fractures - p. 1043 84. References - p. 1060 85. 34 Fractures in the Ankylosed Spine - p. 1065 86. 35 Osteoporotic Spinal Fractures - p. 1073 87. 36 Avoiding Complications in Spine Trauma Patients - p. 1086 88. 37 Principles of Orthotic Management - p. 1098 89. Section Three Pelvis - p. 1105 90. Introduction - p. 1107 91. 38 Pelvic Ring Injuries - p. 1108 92. Introduction - p. 1108 93. Anatomy - p. 1108 94. Pelvic Stability and Biomechanics - p. 1113 95. Trauma Mechanism and Pathomechanics of Pelvic Injuries - p. 1115 96. Radiologic Diagnostics in Pelvic Injuries - p. 1117 97. Classification of Pelvic Injuries - p. 1121 98. Acute Management - p. 1135 99. Emergency Management - p. 1138 100. Definitive Management - p. 1149 101. Conservative Treatment of Pelvic Ring Fractures - p. 1179 102. Postoperative Treatment - p. 1180 103. Complications - p. 1182 104. Genitourinary Injuries - p. 1184 105. Open Pelvic Fractures - p. 1185 106. Outcome - p. 1187 107. References - p. 1188 108. 39 Surgical Treatment of Acetabular Fractures - p. 1196 109. Epidemiology - p. 1196 110. Osteology - p. 1196 111. Radiology - p. 1198 112. Classification - p. 1202 113. Decision Making - p. 1216 114. Operative Timing - p. 1221 115. Initial Management - p. 1222 116. Surgical Exposures - p. 1223 117. Manipulative Reduction and Percutaneous Fixation - p. 1231 118. Exposure, Reduction, and Fixation by Fracture Pattern - p. 1231 119. Aftercare - p. 1247 120. Complications - p. 1250 121. Summary - p. 1254.e1 122. References - p. 1254.e1 123. Section Four Upper Extremity - p. 1260 124. Introduction - p. 1261 125. 40 Fractures and Dislocations of the Hand - p. 1262 126. The Thumb Ray - p. 1262 127. Intraarticular Carpometacarpal Fractures of the Thumb Metacarpal - p. 1262 128. Extraarticular Fractures of the Thumb Metacarpal - p. 1267 129. Ligamentous Injuries - p. 1267 130. Metacarpal Fractures (Excluding the Thumb) - p. 1276 131. Metacarpophalangeal Joint Ligamentous Injuries - p. 1293 132. Phalangeal Fractures and Interphalangeal Joint Injuries - p. 1294 133. References - p. 1312 134. 41 Fractures and Dislocations of the Carpus - p. 1318 135. Fractures of the Scaphoid - p. 1318 136. Other Carpal Fractures - p. 1335 137. Dislocation of the Carpus - p. 1343 138. References - p. 1365 139. 42 Fractures of the Distal Radius - p. 1373 140. 43 Diaphyseal Fractures of the Forearm - p. 1429 141. 44 Trauma to the Adult Elbow - p. 1470 142. 45 Fractures of the Distal Humerus - p. 1488 143. 46 Fractures of the Humeral Shaft - p. 1518 144. 47 Proximal Humeral Fractures and Glenohumeral Dislocations - p. 1535 145. Essential Principles for Treatment of Proximal Humeral Fractures and Glenohumeral Dislocations - p. 1535 146. Proximal Humeral Fractures and Fracture-Dislocations - p. 1550 147. Glenohumeral Dislocations - p. 1581 148. Treatment of Fracture Sequelae of the Proximal Humerus - p. 1610 149. References - p. 1625 150. 48 Fractures and Dislocations of the Clavicle - p. 1640 151. 49 Scapula Fractures - p. 1665 152. 50 Chest Wall Trauma - p. 1696 153. 51 Replantation - p. 1721 154. Section Five Lower Extremity - p. 1726 155. Introduction - p. 1727 156. 52 Hip Dislocations - p. 1728 157. 53 Medical Management of the Patient With Hip Fracture - p. 1763 158. 54 Intracapsular Hip Fractures - p. 1779 159. Femoral Head Fractures - p. 1779 160. Femoral Neck Fractures - p. 1797 161. References - p. 1855 162. 55 Intertrochanteric Hip Fractures - p. 1868 163. 56 Posttraumatic Reconstruction of the Hip Joint - p. 1910 164. 57 Subtrochanteric Fractures of the Femur - p. 1925 165. 58 Femoral Shaft Fractures - p. 1990 166. Introduction - p. 1990 167. Epidemiology - p. 1990 168. Anatomic Considerations - p. 1991 169. Pathophysiology: Polytrauma Considerations - p. 1995 170. Patient Assessment and Initial Management - p. 1997 171. Fracture Classification - p. 1998 172. Principles of Management of Diaphyseal Femoral Fractures - p. 2002 173. Special Situations - p. 2025 174. Bone Loss and Nonunion in Femoral Fractures - p. 2033 175. Hardware Failure - p. 2039 176. Summary - p. 2039 177. References - p. 2039 178. 59 Fractures of the Distal Femur - p. 2045 179. Pathology - p. 2045 180. Diagnosis - p. 2049 181. Treatment - p. 2053 182. Complications - p. 2115 183. References - p. 2127 184. 60 Patella Fractures and Extensor Mechanism Injuries - p. 2130 185. 61 Dislocations and Soft Tissue Injuries of the Knee - p. 2146 186. 62 Tibial Plateau Fractures - p. 2181 187. Introduction - p. 2181 188. Biomechanics and Mechanism of Injury - p. 2181 189. Evaluation and Examination - p. 2183 190. Fracture Management - p. 2204 191. Complications - p. 2263 192. Outcomes - p. 2265 193. Conclusion - p. 2270 194. References - p. 2271 195. 63 Malunions and Nonunions About the Knee - p. 2277 196. 64 Tibial Shaft Fractures - p. 2300 197. Introduction - p. 2300 198. Relevant Surgical Anatomy - p. 2300 199. Mechanism of Injury and Biomechanics - p. 2307 200. Diagnosis - p. 2307 201. Management - p. 2311 202. Complications - p. 2350 203. Outcomes of Tibia Shaft Fractures - p. 2362 204. Cost-Effectiveness - p. 2369 205. Acknowledgment - p. 2369 206. References - p. 2369 207. 65 Fractures of the Tibial Pilon - p. 2379 208. Mechanism of Injury - p. 2379 209. Classification - p. 2380 210. Radiographic Evaluation - p. 2382 211. Initial Treatment - p. 2384 212. Plate Fixation - p. 2410 213. External Fixation - p. 2416 214. Tensioned-Wire Technique - p. 2422 215. Wound Closure - p. 2424 216. Open Fractures - p. 2425 217. Flap Coverage - p. 2427 218. Postoperative Care - p. 2427 219. Obesity and Diabetes - p. 2428 220. Nonreconstructible Pilon Fractures - p. 2429 221. Complications - p. 2430 222. Clinical Outcomes - p. 2438 223. Prognosis - p. 2439 224. Summary - p. 2441 225. References - p. 2441 226. 66 Malleolar Fractures and Soft Tissue Injuries of the Ankle - p. 2446 227. 67 Foot Injuries - p. 2497 228. General Principles of Care - p. 2497 229. Evaluation and Initial Management - p. 2498 230. Fractures of the Talus - p. 2498 231. Tarsal Dislocations - p. 2522 232. Calcaneal Fractures - p. 2529 233. Navicular Fractures - p. 2564 234. Tarsometatarsal (Lisfranc) Injuries - p. 2571 235. Cuboid Fractures - p. 2585 236. Cuneiform Fractures - p. 2588 237. Metatarsal Fractures - p. 2588 238. Injury to the Metatarsophalangeal Joints - p. 2600 239. Injury to the Proximal Phalanx and Interphalangeal Joint of the Hallux - p. 2604 240. Injury to the Lesser Phalanges and Interphalangeal Joints - p. 2605 241. Distal Phalanx and Nail Bed Injuries - p. 2607 242. Sesamoid Fractures - p. 2607 243. Foot Compartment Syndrome - p. 2609 244. Mutilating Injuries: the Mangled Foot - p. 2612 245. Thermal Injury - p. 2615 246. Gunshot Wounds - p. 2615 247. Heel Pad Injury - p. 2617 248. Traumatic Tendon Injury - p. 2617 249. Puncture Wounds - p. 2619 250. Neuropathic Foot Fracture - p. 2620 251. Advanced Imaging Modalities for Foot Trauma - p. 2622 252. Acknowledgment - p. 2624 253. References - p. 2624 254. 68 Posttraumatic Reconstruction of the Foot and Ankle - p. 2641 255. 69 Periprosthetic Fractures of the Lower Extremity - p. 2691 256. 70 Principles of Deformity Correction - p. 2725 257. 71 Limb Salvage and Reconstruction - p. 2788 258. 72 Amputations in Trauma - p. 2805 259. 73 Articular Cartilage Reconstruction Using Osteochondral Allografts - p. 2839 260. Section Six Legacy Chapters - p. 2859 261. Introduction - p. 2861 262. 74 The History of Fracture Treatment - p. e1 263. 75 Occupational Hazards in the Treatment of Orthopaedic Trauma - p. e31 264. 76 Medical Management of the Orthopaedic Trauma Patient - p. e49 265. Acute Pain Management, Regional Anesthesia Techniques, and Management of Complex Regional Pain Syndrome - p. e49 266. Treatment Options - p. e52 267. Assessment - p. e53 268. Pharmacotherapy - p. e54 269. Diagnosis and Differential - p. e59 270. Initiation and Assessment of Therapy - p. e60 271. Complex Regional Pain Syndrome - p. e74 272. Perioperative Assessment - p. e76 273. Pulmonary Risk Assessment - p. e77 274. Medications - p. e78 275. Ordering Tests - p. e81 276. Diabetes Mellitus - p. e81 277. Obstructive Sleep Apnea - p. e82 278. Liver Disease - p. e82 279. Preventing Complications - p. e83 280. Management of the Pregnant Woman - p. e85 281. Substance Abuse Syndromes: Recognition, Prevention, and Treatment - p. e90 282. References - p. e100 283. 77 Surgical Site Infection Prevention - p. e107 284. 78 Physical Impairment Ratings for Fractures - p. e120 285. 79 Outcome Assessment in Orthopaedic Traumatology - p. e128 286. 80 Professionalism and the Economics of Orthopaedic Trauma Care - p. e138 287. Index - p. I-1