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دانلود کتاب Campbell's Operative Orthopaedics
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Campbell's Operative Orthopaedics
دسته بندی: پزشکی ویرایش: 14 نویسندگان: Frederick M. Azar, S. Terry Canale, James H. Beaty سری: ناشر: Elsevier سال نشر: 2020 تعداد صفحات: 5036 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 275 مگابایت
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Cover List of Techniques Campbell’s Operative Orthopaedics Copyright Dedication Contributors Preface Part I: General Principles Chapter 1: Surgical Techniques Surgical Techniques Tourniquets Radiographs in the Operating Room Preventing Mistakes Positioning of the Patient Local Preparation of the Patient Wound Irrigating Solutions Draping Draping the Edges of the Incision Prevention of Human Immunodeficiency Virus and Hepatitis Virus Transmission Reversing Prophylactic Anticoagulation Prior to Surgery Blood Loss Control During Surgery Venous Thromboembolism Prophylaxis Postoperative Pain Control Special Operative Techniques Methods of Tendon-to-Bone Fixation Suture Anchors Suture Buttons Bone Grafting Structure of Bone Grafts Sources of Bone Grafts Autogenous Grafts Allogenic Grafts Bone Bank Cancellous Bone Graft Substitutes Indications for Various Bone Graft Techniques Onlay Cortical Grafts Inlay Grafts Multiple Cancellous Chip Grafts Hemicylindrical Grafts Whole-Bone Transplant Conditions Favorable for Bone Grafting Preparation of Bone Grafts Cancellous Iliac Crest Bone Grafts Surgical Approaches Toes Approaches to the Metatarsophalangeal Joint of the Great Toe Calcaneus Tarsus and Ankle Anterior Approaches Lateral Approaches to the Tarsus and Ankle Medial Approaches Tibia Tibial Plateau Approaches Fibula Knee Anteromedial and Anterolateral Approaches Posterolateral and Posteromedial Approaches to the Knee Medial Approaches to the Knee and Supporting Structures Lateral Approaches to the Knee and Supporting Structures Direct Posterior, Posteromedial, and Posterolateral Approaches to the Knee Femur Hip Anterior Approaches to the Hip Lateral Approaches to the Hip Posterior Approaches to the Hip Medial Approach to the Hip Acetabulum and Pelvis Anterior Approaches to the Acetabulum Posterior Approaches to the Acetabulum Extensile Acetabular Approaches Ilium Symphysis Pubis Sacroiliac Joint Spine Sternoclavicular Joint Acromioclavicular Joint and Coracoid Process Shoulder Anteromedial Approaches to the Shoulder Anterior Axillary Approach to the Shoulder Anterolateral Approaches to the Shoulder Posterior Approaches to the Shoulder Humerus Approaches to the Distal Humeral Shaft Elbow Posterior Approaches to the Elbow Lateral Approaches Radius Ulna Wrist Hand References Supplemental References Chapter 2: Advanced Imaging in Orthopaedics Magnetic Resonance Imaging MRI Technology and Technique Contraindications Contrast Agents in MRI Foot and Ankle Tendon Injuries Ligament Injuries Osseous Injuries Other Disorders of Foot and Ankle Knee Pathologic Conditions of Menisci Cruciate Ligament Injury Other Knee Problems Hip Osteonecrosis Transient Osteoporosis Trauma Spine Intervertebral Disc Disease Postoperative Back Pain Spinal Tumors Spinal Trauma Shoulder Pathologic Conditions of the Rotator Cuff Impingement Syndromes Pathologic Conditions of Labrum Other Causes of Shoulder Pain Wrist and Elbow Carpal Ligament Disruptions Other Pathologic Conditions of Hand and Wrist Elbow Tumor Imaging Computed Tomography CT Technology and Technique Trauma Developmental Skeletal Pathology Arthropathy Tumor Evaluation Conclusion References Supplemental References Part II: Reconstructive Procedures of the Hip in Adults Chapter 3: Arthroplasty of the Hip Applied Biomechanics Forces acting on the hip Stress transfer to bone Design and Selection of Total Hip Components Femoral components Cemented femoral components Cementless femoral components Specialized and custom-made femoral components Acetabular components Cemented acetabular components Cementless acetabular components Alternative bearings Highly crosslinked polyethylene Ceramic-On-Ceramic Bearings Indications and Contraindications for Total Hip Arthroplasty Preoperative Patient Evaluation and Optimization Preoperative Radiographs The Hip-Spine Relationship Preparation and Draping Surgical Approaches and Techniques Total hip arthroplasty through posterolateral approach Component implantation Total hip arthroplasty through the direct anterior approach Minimally invasive techniques Computer-assisted surgery Trochanteric osteotomy Surgical Problems Relative to Specific Hip Disorders Arthritic disorders Osteoarthritis (primary or secondary hypertrophic arthritis or degenerative arthritis) Inflammatory arthritis Osteonecrosis Protrusio acetabuli Developmental dysplasia Legg-Calvé-Perthes disease Slipped capital femoral epiphysis Dwarfism Traumatic and posttraumatic disorders Acute femoral neck fractures Failed hip fracture surgery Acetabular fractures Failed reconstructive procedures Proximal femoral osteotomy and deformity Acetabular osteotomy Arthrodesis and ankylosis Metabolic disorders Paget disease Gaucher disease Sickle cell anemia Chronic renal failure Hemophilia Infectious disorders Pyogenic arthritis Tuberculosis Tumors Neuromuscular disorders Complications Mortality Hematoma formation Heterotopic ossification Thromboembolism Neurologic injuries Vascular injuries Limb-length discrepancy Dislocation Fractures Trochanteric nonunion Infection Antibiotic prophylaxis Classification Diagnosis Management Early Postoperative Infection Late Chronic Infection Acute Hematogenous Infection Reconstruction after infection Loosening Femoral loosening Cemented femoral components Cementless Femoral Components Acetabular loosening Cemented Acetabular Components Cementless Acetabular Components Diagnosis Osteolysis Adverse local tissue reaction Revision of Total Hip Arthroplasty Indications and Contraindications Preoperative planning Surgical approach Removal of the femoral component Removal of femoral cement Removal of the acetabular component Cemented Acetabular Component Reconstruction of acetabular deficiencies Classification Management Segmental deficits Combined deficits Pelvic discontinuity Reconstruction of femoral deficiencies Classification Management Segmental deficits Cavitary deficits Massive deficits Femoral deformity Postoperative Management of Total Hip Arthroplasty References Supplemental References Chapter 4: Surface Replacement Hip Arthroplasty Results Indications and Patient Selection Preoperative Radiographic Evaluation and Templating Postoperative Management Revision of Surface Replacement Arthroplasty Components References Supplemental References Chapter 5: Arthrodesis of the Hip Indications and Results Techniques Arthrodesis of the Proximal Femur to the Ischium Total Hip Arthroplasty After Hip Arthrodesis References Supplemental References Chapter 6: Hip Pain in the Young Adult and Hip Preservation Surgery Evaluation and History Patient History Physical Examination Radiographic Assessment Femoroacetabular Impingement Surgical Indications Surgical Dislocation of the Hip Results Combined Hip Arthroscopy and Limited Open Osteochondroplasty Results Periacetabular Osteotomy Surgical Technique Results Hip Arthroscopy Extraarticular Hip Impingement Hip Dysplasia Periacetabular Osteotomy Surgical Indications Surgical Technique Results Complications Following Periacetabular Osteotomy Hip Arthroscopy With Borderline Hip Dysplasia Total Hip Replacement Following Periacetabular Osteotomy Extraarticular Sources of Hip Pain Greater Trochanteric Pain Syndrome Gluteus Medius and Minimus Tears Endoscopic Repair of the Hip Abductors External Snapping Hip (External Coxa Saltans) Internal Snapping Hip Osteitis Pubis Sports Hernia (Athletic Pubalgia) Osteonecrosis of the Femoral Head Diagnosis Treatment Nonoperative Treatment Core Decompression Bone Grafting Vascularized Fibular Grafting Proximal Femoral Osteotomy Arthroplasty Idiopathic Transient Osteoporosis Protrusio Acetabuli Adult-Onset Rheumatoid Arthritis Juvenile Idiopathic Arthritis Osteoarthritis Neuropathic Arthropathy (Charcot Joint) References Supplemental References Part III: Reconstructive Procedures of the Knee in Adults Chapter 7: Arthroplasty of the Knee Modern Prosthesis Evolution and Design Varus-valgus constrained prostheses Mobile-bearing prostheses Unicompartmental prostheses Hinged implants Knee replacement systems Knee and Implant Biomechanics Functional anatomy and kinematics Role of the posterior cruciate ligament in total knee arthroplasty Axial and rotational alignment of the knee Patellofemoral joint biomechanics and functional anatomy Polyethylene and bearing choices Component fixation Indications and Contraindications Total knee arthroplasty Unicondylar knee arthroplasty Patellofemoral arthroplasty Indications and considerations for patellar resurfacing in primary total knee arthroplasty Indications and considerations for simultaneous bilateral total knee arthroplasty Considerations for outpatient knee joint arthroplasty Results of Primary Total Knee Arthroplasty Functional and radiographic outcome measures Prosthesis survival Preoperative evaluation Ambulatory and short-stay considerations Anesthetic options Pain management strategies after partial and total knee arthroplasty Blood preservation management in partial and total knee arthroplasty Surgical Technique for Primary Total Knee Arthroplasty Intramedullary and extramedullary alignment instrumentation Computer-assisted alignment technique Robotic-assisted surgery considerations Custom cutting blocks Soft-tissue balancing Soft-tissue balancing techniques (pie-crusting or standard release) Management of bone deficiency Patellofemoral tracking Wound closure Arthroplasty Techniques (Unicondylar and Patellofemoral Knee Arthroplasties) Postoperative management Surgical Problems Relative to Specific Disorders Previous high tibial osteotomy Previous patellectomy Neuropathic arthropathy Other medical conditions Complications Thromboembolism Infection Patellofemoral complications Neurovascular complications Periprosthetic fractures Revision Total Knee Arthroplasty Aseptic failure of primary total knee arthroplasty Surgical exposures Component removal Knee revision and reconstruction principles Results References Supplemental References Chapter 8: Arthrodesis of the Knee Indications and Results Techniques Compression Arthrodesis With External Fixation Arthrodesis With Intramedullary Rod Fixation Arthrodesis With Plate Fixation References Supplemental References Chapter 9: Soft-Tissue Procedures and Osteotomies About the Knee Muscle Contractures Quadriceps Contracture of Infancy and Childhood Flexion, Extension, and Combined Contractures Snapping Syndromes Painful Paraarticular Calcifications Tendinitis and Bursitis Prepatellar Bursitis Tibial Collateral Ligament Fibrositis and Bursitis Fibular Collateral Ligament Bursitis Infrapatellar Bursitis Popliteal Cyst (Baker Cyst) Medial Gastrocnemius Bursitis Semimembranosus Bursitis Semimembranosus Tendinitis Chronic Synovitis Synovectomy of the Knee Rheumatoid Arthritis of the Knee Adult-Onset Rheumatoid Arthritis Juvenile Rheumatoid Arthritis Surgical Procedures Arthroscopic Synovectomy Proximal Tibial Osteotomy Arthrodesis Arthroplasty or Reconstruction Osteoarthritis of the Knee Surgical Procedures Debridement Osteochondral and Autologous Chondrocyte Transplantation Proximal Tibial Osteotomy Lateral Closing Wedge Osteotomy Medial Opening Wedge Osteotomy Opening Wedge Hemicallotasis General Complications of High Tibial Osteotomy Total Knee Arthroplasty after Proximal Tibial Osteotomy Distal Femoral Osteotomy References Supplemental References Part IV: Reconstructive Procedures of the Ankle in Adults Chapter 10: Total Ankle Arthroplasty Development of Total Ankle Arthroplasty Systems Design Rationale Fixed-Bearing Versus Mobile-Bearing Designs Alignment Ingrowth Versus Cement Fixation Metaphyseal Fixation Talar Component Design Polyethylene Wear Preoperative Evaluation Indications Total Ankle Arthroplasty or Ankle Arthrodesis for Ankle Arthritis Outpatient Total Ankle Arthroplasty Considerations for Adjunctive Procedures Deformity Correction Ligament Considerations Special Circumstances Inflammatory Arthritis Obesity Diabetes Osteonecrosis of the Talus Pantalar Disease; Concomitant Hindfoot Arthrodesis Takedown of Ankle Arthrodesis and Conversion to Ankle Arthroplasty Gout Bilateral Total Ankle Arthroplasty Outcomes Sports Participation Role of Experience and Numbers of Cases Range of Motion By Diagnosis Complications In-Hospital Complications Wound Healing Complications Osteolysis, Loosening, and Subsidence Malalignment Polyethylene Failure Fracture Infection Deep Venous Thrombosis Heterotopic Ossification Medial Malleolar Pain Progression of Arthritis in Adjacent Joints Osteophyte Formation/Impingement Revision Ankle Arthroplasty References Supplemental References Chapter 11: Ankle Arthrodesis Alternatives to Ankle Arthrodesis Nonoperative treatment Operative treatment Joint debridement Periarticular osteotomies Distraction arthroplasty Total ankle arthroplasty Indications for Ankle Arthrodesis Patient Evaluation Clinical evaluation Radiographic evaluation Techniques of Ankle Arthrodesis Arthroscopic arthrodesis Arthrodesis with external fixation Special Considerations Osteonecrosis of the talus Failed total ankle arthroplasty Infection/osteomyelitis Charcot neuroarthropathy Bone graft/supplementation Complications Nonunion Treatment Adjacent joint pain and arthritis References Supplemental References Part V: Reconstructive Procedures of the Shoulder and Elbow in Adults Chapter 12: Shoulder and Elbow Arthroplasty Reconstructive Procedures of the Shoulder History Anatomy and Biomechanics Prosthesis Design Clinical Presentation and Radiographic Evaluation Preoperative Planning Hemiarthroplasty Indications Surgical Technique Outcomes Modified Hemiarthroplasty: Interposition Arthroplasty and Glenoidplasty (Ream and Run) Resurfacing Hemiarthroplasty Total Shoulder Arthroplasty Indications Surgical Technique Outcomes Osteoarthritis Inflammatory Arthritis Posttraumatic Arthritis and Posttraumatic Sequelae Osteonecrosis Capsulorrhaphy Arthropathy and Arthropathy of Recurrent Instability Reverse Total Shoulder Arthroplasty Indications Surgical Technique Outcomes Cuff Tear Arthropathy Rotator Cuff Dysfunction Without Arthritis Proximal Humeral Fractures Rheumatoid Arthritis with Rotator Cuff Tear Salvage Procedures Glenoid Bone Loss Activities After Shoulder Arthroplasty Complications of Shoulder Arthroplasty Intraoperative Complications Postoperative Complications Glenoid Loosening Humeral Loosening Instability Periprosthetic Fracture Rotator Cuff Failure Infection Deltoid Muscle Dysfunction Heterotopic Ossification Stiffness Complications of Reverse Total Shoulder Arthroplasty Revision Shoulder Arthroplasty Indications Outcomes Other Surgical Options for Failed Shoulder Arthroplasty Hemiarthroplasty Resection Arthroplasty Glenohumeral Arthrodesis Rehabilitation After Shoulder Arthroplasty Reconstructive Procedures of the Elbow Anatomy and Biomechanics Types of Arthroplasty Debridement Arthroplasty Interposition (Fascial) Arthroplasty Resection and Implant Arthroplasty of the Radial Head Radial Head Arthroplasty Total Elbow Arthroplasty Indications Surgical Technique Semiconstrained (Linked) Total Elbow Arthroplasty Outcomes Unconstrained Total Elbow Arthroplasty Semiconstrained Total Elbow Arthroplasty Complications Salvage Revision Elbow Arthroplasty Resection Arthroplasty References Supplemental References Chapter 13: Salvage Operations for the Shoulder and Elbow Shoulder Arthrodesis Indications Position Surgical Techniques Complications Outcomes Elbow Arthrodesis Indications Surgical Techniques Complications Outcomes Tendon Transfers for Irreparable Rotator Cuff Tears Indications Surgical Techniques Latissimus Dorsi Tendon Transfer for Irreparable Posterior Superior Rotator Cuff Tears Outcomes Lower Trapezius Tendon Transfer for Irreparable Posterior Superior Rotator Cuff Tears Outcomes Pectoralis Major Tendon Transfer for Irreparable Subscapularis Tears Outcomes Latissimus Dorsi Tendon Transfer for Irreparable Subscapularis Tears Outcomes Complications References Supplemental References Part VI: Amputations Chapter 14: General Principles of Amputations Incidence and Indications Peripheral Vascular Disease Trauma Burns Frostbite Infection Tumors Surgical Principles of Amputations Determination of Amputation Level Technical Aspects Skin and Muscle Flaps Hemostasis Nerves Bone Open Amputations Postoperative Care Complications Hematoma Infection Wound Necrosis Contractures Pain Dermatologic Problems Amputations in Children References Supplemental References Chapter 15: Amputations of the Foot Toe Amputations Midfoot Amputations Hindfoot and Ankle Amputations References Supplemental References Chapter 16: Amputations of the Lower Extremity Foot and Ankle Amputations Transtibial (Below-Knee) Amputations Nonischemic Limbs Rehabilitation in Nonischemic Limbs Ischemic Limbs Rehabilitation in Ischemic Limbs Disarticulation of the Knee Transfemoral (Above-Knee) Amputations Rehabilitation after Transfemoral Amputation References Supplemental References Chapter 17: Amputations of the Hip and Pelvis Disarticulation of the Hip External Hemipelvectomy (Hindquarter Amputation) References Supplemental References Chapter 18: Major Amputations of the Upper Extremity Hand Amputations Wrist Amputations Forearm Amputations (Transradial) Elbow Disarticulation Arm Amputations (Transhumeral) Shoulder Amputations Forequarter Amputations Targeted Muscle Reinnervation (TMR) After Shoulder or Transhumeral Amputation References Supplemental References Chapter 19: Amputations of the Hand Considerations for Amputation Principles of Finger Amputations Fingertip Amputations Free Skin Graft Flaps for Fingertip Coverage Amputations of Single Fingers Index Finger Middle or Ring Finger Ray Amputations Ring Avulsion Injuries Little Finger Amputations Thumb Amputations Amputations of Multiple Digits Painful Amputation Stump Reconstructions After Amputation Reconstruction After Amputation of the Hand Reconstruction After Amputation of Multiple Digits Reconstruction of the Thumb Pollicization References Supplemental References Part VII: Infections Chapter 20: General Principles of Infection Etiology Patient-Dependent Factors Nutritional Status Glucose Rheumatoid Arthritis Immunologic status Surgeon-Dependent Factors Skin preparation Operating room environment Prophylactic antibiotic therapy Methicillin-Resistant Staphylococcus Aureus Diagnosis Laboratory studies Imaging studies Culture studies Treatment Human Immunodeficiency Virus and Hepatitis B and C Diagnostic tests Confirmatory tests Musculoskeletal syndromes in human immunodeficiency virus–infected patients Risks and prevention References Supplemental References Chapter 21: Osteomyelitis Classification Acute Hematogenous Osteomyelitis Diagnosis Treatment Subacute Hematogenous Osteomyelitis Brodie abscess Chronic Osteomyelitis Classification Diagnosis Treatment Management of defects Polymethylmethacrylate antibiotic bead chains Biodegradable antibiotic delivery systems Closed suction drains Soft-tissue transfer External fixation Adjunctive therapies Sclerosing Osteomyelitis of Garré Residual Stage of Osteomyelitis Chronic Recurrent Multifocal Osteomyelitis Anaerobic Osteomyelitis Incision and Drainage for Osteomyelitis of Specific Regions Calcaneus Pelvic regions Ilium Ischium and pubis Spine Resection or Excision for Osteomyelitis Resection of the tarsals Amputation for Osteomyelitis References Supplemental References Chapter 22: Infectious Arthritis Clinical Presentation Synovial Fluid Studies Imaging Studies Pathogenesis Microbiology Treatment Tarsal Joints Ankle Aspiration Drainage Ankle Arthroscopy Knee Aspiration Drainage Arthroscopic Drainage of the Knee Hip Aspiration Drainage Arthroscopic Drainage Complications of Acute Septic Arthritis of the Hip Pathologic Dislocation Osteomyelitis Pelvic Abscess Persistent Infection Sacroiliac Joint Spine Sternoclavicular and Acromioclavicular Joints Shoulder Aspiration Drainage Arthroscopic Drainage of the Shoulder Elbow Aspiration Drainage Arthroscopy of the Elbow Wrist Aspiration Drainage Arthroscopy of the Wrist Operations to Correct Deformities After Septic Arthritis Ankle Knee Intraarticular Osteotomy Hip Arthroplasty Operations to Stabilize the Hip Operations to Correct Deformity Operations to Equalize Leg Lengths References Supplemental References Chapter 23: Tuberculosis and other Unusual Infections Tuberculosis North American demographics Musculoskeletal Involvement Laboratory Findings Imaging Nonoperative Treatment of Appendicular Tuberculous Infections Operative Treatment Foot Excision of Bones Ankle Knee Hip Arthrodesis Evacuation of Abscesses Sacroiliac Joint Pubis Clavicle Shoulder Elbow Arthrodesis Wrist and Hand Tuberculosis of Long Bones Amputation Other Unusual Infections Nontuberculous Mycobacterial Infections Brucellosis Typhoid Fever Syphilis Anaerobic Infections Viral Osteitis and Arthritis Actinomycosis Lyme Disease Fungal Infection Coccidioidomycosis Blastomycosis Histoplasmosis Cryptococcosis Sporotrichosis Echinococcosis References Supplemental References Part VIII: Tumors Chapter 24: General Principles of Tumors Diagnostic Evaluation General approach to musculoskeletal neoplasms Physical examination Radiographic examination Other imaging examinations Laboratory tests Metastases of unknown origin Staging Biopsy Adjuvant Treatment Radiation therapy Chemotherapy Principles of Surgery Amputation versus limb salvage Margins Curettage Resection and reconstruction Considerations for pediatric patients Surgical Techniques Upper extremity Resection of the shoulder girdle Resection of the clavicle Resection of the scapula Resection of the distal ulna Resection of the hand Pelvis Lower extremity Resection of the distal femur Resection-arthrodesis of the ankle Resection of the talus Rotationplasty References Supplemental References Chapter 25: Benign Bone Tumors and Nonneoplastic Conditions Simulating Bone Tumors Bone-Forming Tumors Osteoid osteoma Bone island Cartilage Lesions Chondroma Osteochondroma Fibrous Lesions Nonossifying fibroma Cortical desmoid Benign fibrous histiocytoma Fibrous dysplasia Osteofibrous dysplasia Desmoplastic fibroma Cystic Lesions Unicameral bone cyst Aneurysmal bone cyst Intraosseous ganglion cyst Epidermoid cyst Fatty Tumors Lipoma Vascular Tumors Hemangioma Other Nonneoplastic Lesions Paget disease “Brown tumor” of hyperparathyroidism Bone infarct Osteomyelitis Stress fracture Posttraumatic osteolysis References Supplemental References Chapter 26: Benign/Aggressive Tumors of Bone Giant Cell Tumor Chondroblastoma Chondromyxoid Fibroma Osteoblastoma Langerhans Cell Histiocytosis References Supplemental References Chapter 27: Malignant Tumors of Bone Osteosarcoma Chondrosarcoma Ewing Sarcoma Chordoma Adamantinoma Malignant Vascular Tumors Malignant Fibrous Histiocytoma and Fibrosarcoma Multiple Myeloma and Plasmacytoma Lymphoma Metastatic Carcinoma References Supplemental References Chapter 28: Soft-Tissue Tumors Benign Tumors and Tumor-Like Lesions Fatty Tumors Nerve Sheath Tumors Synovial Lesions Vascular Lesions Fibrous Lesions Malignant Tumors Malignant Fibrous Histiocytoma/Undifferentiated Pleomorphic Sarcoma Liposarcoma Synovial Sarcoma (Malignant Synovioma) Fibrosarcoma Epithelioid Sarcoma Dermatofibrosarcoma Protuberans Rhabdomyosarcoma Malignant Peripheral Nerve Sheath Tumor Extraskeletal Osteosarcoma Extraskeletal Ewing Sarcoma Extraskeletal Chondrosarcoma References Supplemental References Part IX: Congenital and Developmental Disorders Chapter 29: Congenital Anomalies of the Lower Extremity Anomalies of the Toes Polydactyly Syndactyly Macrodactyly Cleft foot (partial adactyly) Contracture or angulation of the toes Congenital hallux varus Congenital metatarsus adductus Treatment Anomalies of the Foot Congenital clubfoot (talipes equinovarus) Radiographic evaluation Classification Nonoperative treatment Ponseti Casting Technique for Correction of Clubfoot Deformity Management of Recurrence Operative treatment Recalcitrant clubfeet Triple Arthrodesis and Talectomy for Uncorrected Clubfoot Calcaneovalgus foot Congenital vertical talus Clinical and radiographic findings Treatment Triple Arthrodesis Anomalies of the Leg Congenital angular deformities of the leg Posteromedial bowing of the tibia Congenital pseudarthrosis of the fibula and tibia Fibula Tibia Classification Treatment Intramedullary Fixation Vascularized Graft Ilizarov Technique Bone Morphogenetic Protein Complications Stiffness of the Ankle and Hindfoot Refracture Valgus Ankle Deformity Tibial Shortening Constrictions of the Leg Congenital Hyperextension and Dislocation of the Knee Congenital dislocation of the patella Congenital deficiencies of the long bones Tibial hemimelia Classification Treatment Fibular hemimelia Classification Treatment Proximal femoral focal deficiency Classification Treatment Limb-length discrepancy Clinical assessment Radiographic assessment Techniques for predicting growth remaining Treatment Operative Treatment Epiphysiodesis Limb Shortening Limb Lengthening References Supplemental References Chapter 30: Congenital and Developmental Abnormalities of the Hip and Pelvis Developmental Dysplasia of the Hip Diagnosis and Clinical Presentation Screening Imaging Treatment Newborn (Birth to 6 Months) Infant (6 to 18 Months) Preoperative Traction Adductor Tenotomy Arthrography and Closed Reduction Three-Dimensional Imaging After Closed Reduction Open Reduction Concomitant Osteotomy Teratologic Dislocations Osteonecrosis Toddler (18 to 36 Months) Femoral Osteotomy in Dysplasia of the hip Child (3 to 8 Years) Primary Femoral Shortening Pelvic Osteotomy Salter Innominate Osteotomy Pemberton Acetabuloplasty Steel Osteotomy Dega Osteotomy Ganz (Bernese) Periacetabular Osteotomy Shelf Operations Innominate Osteotomy With Medial Displacement of the Acetabulum (Chiari) Adolescent and Young Adult (>8 Years) Congenital and Developmental Coxa Vara Exstrophy of the Bladder Anterior Iliac Osteotomies and Approximation of the Symphysis Pubis References Supplemental References Chapter 31: Congenital Anomalies of the Trunk and Upper Extremity Congenital Elevation of the Scapula (Sprengel Deformity) Congenital Muscular Torticollis Congenital Pseudarthrosis of the Clavicle Congenital Dislocation of the Radial Head Congenital Pseudarthrosis of the Radius Congenital Pseudarthrosis of the Ulna Congenital Radioulnar Synostosis References Supplemental References Chapter 32: Osteochondrosis or Epiphysitis and Other Miscellaneous Affections Legg-Calvé-Perthes Disease Diagnosis Classification Bilateral involvement Imaging Evaluation Treatment Innominate osteotomy Lateral shelf procedure Varus derotational osteotomy Lateral opening wedge osteotomy Arthrodiastasis Reconstructive surgery Osteochondroplasty (Cheilectomy) Valgus extension osteotomy Valgus flexion internal rotation osteotomy Shelf procedure Chiari osteotomy Trochanteric overgrowth Osteochondrosis or Epiphysitis Traction epiphysitis of the fifth metatarsal base (Iselin Disease) Osteochondrosis of the metatarsal head (Freiberg Infraction) Osteochondrosis of the navicular (Köhler Disease) Osteochondritis of the ankle Apophysitis of the tibial tuberosity (Osgood-Schlatter Disease) Osteochondritis dissecans of the knee Osteochondritis dissecans of the patella Osteochondritis dissecans of the hip Osteochondrosis of the capitellum (Osteochondritis Dissecans) Tibia Vara (Blount Disease) Osteotomies Neurovascular complications of high tibial osteotomy Rickets, Osteomalacia, and Renal Osteodystrophy Hemophilia Total joint arthroplasty Synovectomy Arthroscopic synovectomy Open ankle synovectomy Arthrodesis Osteotomy Complications of hemophilia Congenital Affections Osteogenesis imperfecta Multiple osteotomies, realignment, and medullary nail fixation Fassier-duval telescoping rod (Pega Medical, inc., Laval, Quebec, Canada) Osteotomy and medullary nailing with locked nail Dwarfism (Short Stature) Traumatic physeal arrest from bridge of bone References Supplemental References Part X: Nervous System Disorders in Children Chapter 33: Cerebral Palsy Etiology Classification Geographic Classification Monoplegia Hemiplegia Diplegia Quadriplegia Total Body Other Types Physiologic Classification Spastic Athetoid Choreiform Rigid Ataxic Hypotonic Mixed Functional Classification Diagnosis Prognostic Factors Gait Analysis Associated Conditions Treatment Nonoperative Treatment Operative Treatment Neurosurgical Intervention Hip Flexion Deformities Adduction Deformities Subluxation and Dislocation Varus Derotational Osteotomy Redirectional Osteotomy Knee Hip and Knee Relationships Flexion Deformity Combined Hamstring Lengthening, Posterior Capsular Release Distal Transfer of Rectus Femoris Recurvatum of the Knee Knee Valgus Patella Alta Rotational Abnormalities Foot and Ankle Equinus Deformity Surgical Correction of Equinus Deformity Lengthening of the Gastrocnemius-Soleus Muscle Complex Varus or Valgus Deformity Equinovarus Deformity Lengthening of the Posterior Tibial Tendon Split Tendon Transfers Osteotomy of the Calcaneus Lateral Displacement Calcaneal Osteotomy Planovalgus Deformity Calcaneus Deformity Cavus Deformity Forefoot Adduction Deformity Correction of Flexible Forefoot Adductus Hallux Valgus Deformity Claw Toes Spine-Pelvic Obliquity and Scoliosis Upper Extremity Shoulder Elbow Forearm, Wrist, and Hand Adults With Cerebral Palsy Adult Stroke Patients Lower Extremity Hip Knee Foot Talipes Equinus Talipes Equinovarus Varus Foot Planovalgus Toe Flexion Upper Extremity Shoulder Elbow Phenol Nerve Block Functional Electrical Nerve Stimulation References Supplemental References Chapter 34: Paralytic Disorders Poliomyelitis Pathologic findings Clinical course and treatment Acute stage Convalescent stage Chronic stage Tendon transfers Arthrodesis Foot and ankle Tendon transfers Paralysis of Specific Muscles Anterior Tibial Muscle Anterior and Posterior Tibial Muscles Posterior Tibial Muscle Anterior Tibial, Toe Extensor, and Peroneal Muscles Peroneal Muscles Peroneal and Long Toe Extensor Muscles Gastrocnemius-Soleus Muscles Flail Foot Dorsal Bunion Bony procedures (Osteotomy and Arthrodesis) Calcaneal Osteotomy Dillwyn Evans Osteotomy Subtalar Arthrodesis Triple Arthrodesis Complications of Triple Arthrodesis Talectomy Ankle Arthrodesis Pantalar Arthrodesis Tendon transfer techniques Talipes Equinovarus Split Transfer of the Posterior Tibial Tendon Talipes Cavovarus Talipes Equinovalgus Talipes Calcaneus Knee Flexion contracture of the knee Quadriceps paralysis Genu recurvatum Soft-Tissue Operations for Genu Recurvatum Flail knee Tibia and femur Hip Flexion and abduction contractures of the hip Paralysis of the gluteus maximus and medius muscles Paralytic dislocation Of the hip Leg-length discrepancy Total joint arthroplasty Trunk Pelvic obliquity Treatment Serratus Anterior Paralysis Trapezius and Levator Scapulae Paralysis Paralytic Scoliosis Shoulder Tendon and muscle transfers for paralysis of the deltoid Tendon and muscle transfers for paralysis of the subscapularis, suprascapularis, supraspinatus, or infraspinatus Arthrodesis Elbow Muscle and tendon transfers to restore elbow flexion Muscle transfers for paralysis of the triceps Posterior Deltoid Transfer (Moberg Procedure) Forearm Pronation contracture Wrist and hand Myelomeningocele Epidemiology Associated Conditions Hydrocephalus Hydrosyringomyelia Arnold-chiari malformation Tethered spinal cord Other spinal abnormalities Urologic dysfunction Bowel dysfunction Latex hypersensitivity Miscellaneous medical issues Classification Orthopaedic evaluation Gait evaluation Principles of orthopaedic management Nonoperative management Operative management Foot Equinus deformity Clubfoot Varus Deformity Cavovarus deformity Supination deoformity Calcaneal deformity Hindfoot valgus Vertical talus Pes cavus deformity Toe deformities Ankle Hemiepiphysiodesis of the distal tibial epiphysis Knee Flexion contracture Extension contracture Varus or valgus deformity Hip Flexion contracture Flexion-abduction–external rotation contracture External rotation contracture Abduction contracture Adduction Contracture Hip subluxation and dislocation Pelvic obliquity Spine Scoliosis Kyphosis Kyphectomy Arthrogryposis Multiplex Congenita Treatment Lower extremity Scoliosis Brachial Plexus Palsy Clinical features Treatment References Supplemental References Chapter 35: Neuromuscular Disorders Treatment Considerations Bone Health—Osteoporosis and Fracture Management Orthoses Seating Systems Differentiation of Muscle Disease From Nerve Disease Hematologic Studies Electromyographic Studies Muscle Tissue Biopsy Muscular Dystrophy Duchenne Muscular Dystrophy Physical Examination Medical Treatment Orthopaedic Treatment Rideau Technique Other Variants of Muscular Dystrophy Becker Muscular Dystrophy Emery-Dreifuss Muscular Dystrophy Limb-Girdle Dystrophy Facioscapulohumeral Muscular Dystrophy Infantile Facioscapulohumeral Muscular Dystrophy Congenital Dystrophies Myotonic Dystrophy Hereditary Motor and Sensory Neuropathies Charcot-Marie-Tooth Disease (Peroneal Muscular Atrophy) Cavovarus Foot Deformity Clinical and Radiographic Evaluation Orthopaedic Treatment Hip Dysplasia Spinal Deformities Friedreich Ataxia Spinal Muscular Atrophy References Supplemental References Part XI: Fractures and Dislocations in Children Chapter 36: Fractures and Dislocations in Children General Principles Growth Plate Injuries Open Fractures Birth Fractures Nonaccidental Trauma Clavicle Sternoclavicular Fractures and Dislocations Lateral (Distal) Clavicular Fractures Acromioclavicular Dislocations Shoulder Dislocations Proximal Humeral Fractures Closed Treatment Operative Treatment Humeral Shaft Fractures Supracondylar Humeral Fractures Lateral Condylar Fractures Complications After Lateral Condylar Fracture Medial Condylar Fractures Complications After Medial Condylar Fracture Medial Epicondylar Fractures Complications After Medial Epicondylar Fracture Chronic Medial Epicondyle Apophysitis (Little League Elbow) Distal Humeral Fractures Treatment Capitellar Fractures Olecranon Fractures Radial Head and Neck Fractures Complications After Radial Neck Fracture Coronoid Fractures Elbow Dislocations Complications After Elbow Dislocation Radial Head Dislocations (Monteggia Fracture-Dislocations) Galeazzi Fractures Nursemaid’s Elbow Forearm Fractures Proximal Third Forearm Fractures Middle Third Forearm Fractures Plastic Deformation and Greenstick Fractures Distal Third Forearm Fractures Wrist Dislocations Scaphoid and Carpal Fractures Metacarpal Fractures Thumb Metacarpal Fractures Phalangeal Fractures Distal Phalangeal Fracture Complications of Phalangeal Fractures Pediatric Spine Fractures and Dislocations Cervical Spine Atlantooccipital Fractures and Instability Upper Cervical Spine (C1–C2) Injuries Rotatory Subluxation Lower Cervical Spine (C3–C7) Injuries Thoracolumbar Spine Pelvic Fractures Avulsion Fractures Acetabular Fractures Hip Fractures Type I, Transepiphyseal Separations Type II, Transcervical Fractures Type III, Cervicotrochanteric Fractures Type IV, Intertrochanteric Fractures Complications Traumatic Hip Dislocations Slipped Capital Femoral Epiphysis Treatment In Situ Pin or Screw Fixation Contralateral Slips Open Techniques Complications Osteonecrosis Chondrolysis Femoral Neck Fracture Continued Slipping Femoroacetabular Impingement Femoral Fractures Femoral Shaft Fractures (Diaphyseal Femoral Fractures) Spica Casting External Fixation Intramedullary Nailing Plating Complications Fractures of the Distal Femoral Physis Complications Knee Fractures and Dislocations Patellar Dislocations Patellar Fractures Fractures of the Intercondylar Eminence of the Tibia Tibial Tuberosity Fractures Osteochondral Fractures Floating Knee Injuries Tibial and Fibular Fractures Proximal Tibial Physeal Fractures Proximal Tibial Metaphyseal Fractures Middle and Distal Tibial Shaft Fractures Distal Tibial and Fibular Epiphyseal Fractures Triplane Fractures Tillaux Fractures Foot Fractures Talar Fractures Talar Neck Fractures Fractures of the Dome and Lateral Process of the Talus Osteochondral Fractures of the Talus Calcaneal Fractures Tarsal Fractures Metatarsal and Phalangeal Fractures References Supplemental References Part XII: The Spine Chapter 37: Anatomic Approaches to the Spine Anatomy of Vertebral Column Anatomy of Spinal Joints Anatomy of Spinal Cord and Nerves Anatomy of Cervical, Thoracic, and Lumbar Pedicles Circulation of Spinal Cord Surgical Approaches Anterior approaches Anterior approach, occiput to C3 Extended maxillotomy and subtotal maxillectomy Anterior approach, C3 to C7 Anterolateral approach, C2 to C7 Anterior approach to cervicothoracic junction, C7 to T1 Anterior approach to the thoracic spine Video-assisted thoracic surgery Anterior approach to the thoracolumbar junction Anterior retroperitoneal approach, L1 to L5 Percutaneous lateral approach to lumbar spine, L1 to L4-5 (Dlif Or Xlif) Anterior transperitoneal approach to the lumbosacral junction, L5 to S1 Video-assisted lumbar surgery Posterior approaches Minimally Invasive Approaches to the Posterior Spine References Supplemental References Chapter 38: Degenerative Disorders of the Cervical Spine Overview of Disc Degeneration and Herniation in the Cervical Spine Disc and Spine Anatomy Neural Elements Natural History of Disc Disease Diagnostic Studies Radiography Myelography Computed Tomography Magnetic Resonance Imaging Other Diagnostic Tests Injection Studies Epidural Steroid Injections Cervical Epidural Injection Zygapophyseal (Facet) Joint Injections Cervical Discography Cervical Disc Disease Signs and Symptoms Differential Diagnosis Confirmatory Imaging Nonoperative Treatment Operative Treatment Minimally Invasive Posterior Approaches to the Cervical Spine Results Anterior Cervical Arthrodesis General Complications Postoperative Complications Posterior Cervical Arthrodesis Cervical Disc Arthroplasty Rheumatoid Arthritis of the Spine Clinical Evaluation Diagnostic Imaging Radiography Computed Tomographic Myelography and Magnetic Resonance Imaging Cervical Instability Nonoperative Treatment Operative Treatment Ankylosing Spondylitis of the Cervical Spine Diagnosis Treatment Osteotomy of the Cervical Spine References Supplemental References Chapter 39: Degenerative Disorders of the Thoracic and Lumbar Spine Overview of Lumbar and Thoracic Disc Degeneration and Herniation Disc and Spine Anatomy Neural elements Natural History of Disc Disease Axial lumbar pain Diagnostic Studies Radiography Myelography Computed tomography Magnetic resonance imaging Other diagnostic tests Injection studies Epidural cortisone injections Thoracic epidural injection Lumbar epidural injection Zygapophyseal (Facet) joint injections Lumbar Facet Joint Sacroiliac Joint Discography Thoracic Disc Disease Signs and symptoms Confirmatory imaging Treatment results Operative treatment Costotransversectomy Thoracic disc excision Thoracoscopic disc excision Thoracic endoscopic disc excision Lumbar Disc Disease Signs and symptoms Differential diagnosis Confirmatory imaging Nonoperative treatment Operative treatment Microdiscectomy Microscopic Lumbar Disc Excision Tubular Techniques Endoscopic techniques Transforaminal and Interlaminar Endoscopic Lumbar Discectomy Additional exposure techniques Lumbar root anomalies Results of surgery for disc herniation Complications of disc excision Free fat grafting Repeat lumbar disc surgery Disc excision and fusion Thoracic and Lumbar Spine Arthrodesis Anterior arthrodesis Anterior disc excision and interbody fusion of the lumbar spine Minimally invasive anterior fusion of the lumbar spine Posterior arthrodesis Posterolateral or intertransverse fusions Internal fixation in lumbar spinal fusion Treatment after posterior arthrodesis Pseudarthrosis after spinal fusion Degenerative Disc Disease and Internal Disc Derangement Patient selection process Differential spinal anesthetic Psychogenic pain Sympathetic pain Somatic pain Central pain Modified technique Interpretation Thoracic/Lumbar Disc Arthroplasty (Total Disc Replacement) Failed spine surgery Stenosis of the Thoracic and Lumbar Spine Anatomy Natural history Clinical evaluation Diagnostic imaging Radiography Magnetic resonance imaging Computed tomographic myelography Other diagnostic studies Nonoperative treatment Epidural steroid injection Operative treatment Principles of spinal stenosis surgery Adjacent segment degeneration Decompression Less-Invasive Decompression Decompression with fusion Interspinous distraction Ankylosing Spondylitis Osteotomy of the lumbar spine Smith-petersen osteotomy Pedicle subtraction osteotomy Eggshell osteotomy Adult Spinal Deformity Incidence and progression of deformity Classification Sagittal and coronal balance Spinopelvic alignment Clinical evaluation Anatomy and biomechanics Diagnostic imaging Radiography Computed tomographic myelography and magnetic resonance imaging Nonoperative treatment Operative treatment Decompression in degenerative scoliosis Posterior Instrumentation and Fusion Idiopathic Scoliosis Degenerative Scoliosis Anterior spinal instrumentation and fusion Postoperative management Combined anterior and posterior fusions Other techniques Iliac fixation Coccygeal Pain References Supplemental References Chapter 40: Spondylolisthesis General Information Diagnosis Etiology Classification Wiltse Classification of Spondylolisthesis Type 1 Dysplastic Type 2 Isthmic Type 3 Degenerative Type 4 Traumatic Type 5 Pathologic Type 6 Iatrogenic Marchetti-Bartolozzi Classification of Spondylolisthesis Developmental Spondylolisthesis Acquired Spondylolisthesis Acquired Traumatic Spondylolisthesis Acquired Postsurgical Spondylolisthesis Acquired Pathologic Spondylolisthesis Acquired Degenerative Spondylolisthesis Radiographic Pelvic Parameters and Spinopelvic Alignment Natural History Lumbosacral Dysplasia Spondylolysis Patient Presentation Diagnostic Evaluation Evaluation for Operative Treatment Operative Treatment Adult Isthmic Spondylolisthesis Pathophysiology Nonoperative Treatment Operative Treatment Surgical Options Evaluation for Operative Treatment Outcomes of Operative Treatment Operative Planning Degenerative Spondylolisthesis Pathophysiology Nonoperative Treatment Operative Treatment and Outcomes Operative Planning Perioperative Management and Complications Preoperative Management Intraoperative Management Pseudarthrosis Neurologic Deficits Vascular Complications Infection References Supplemental References Chapter 41: Fractures, Dislocations, and Fracture-Dislocations of the Spine Initial Management of Spinal Injury Initial Spine Assessment Spine Precautions Diagnostic Imaging Additional Imaging Neurologic Assessment Spinal Cord Injury Neurogenic And Spinal Shock Immediate Cervical Spinal Reduction Spinal Cord Injury Treatment Spinal Cord Syndromes Cervical Spine Injuries Radiographic Evaluation Protocol Halo Vest Immobilization and Cervical Orthoses Occipitocervical Dissociation Injury Patterns Occipital Condyle Fractures Transverse Atlantal Ligament Rupture Atlas Fractures Treatment of “Stable” C1 Fractures Treatment of “Unstable” C1 Fractures Axis Fractures Odontoid Fractures Treatment Posterior C1-C2 Fusion Techniques Traumatic Spondylolisthesis of the Axis (Hangman Fracture) Treatment Subaxial Cervical Spine Injury (C3-T1) Classification Treatment Extension Injuries Burst Fractures Facet Dislocations Facet Fracture With Subluxation Fracture-Dislocations Ankylosing Spondylitis Vertebral Artery Injuries Thoracic and Lumbar Injuries Classification Treatment Compression Fractures Burst Fractures Distraction Injuries Extension Injuries Fracture-Dislocations Decompression Posterior Stabilization Anterior Stabilization Sacral Fractures and Spinopelvic Dissociation Injuries Classification Treatment References Supplemental References Chapter 42: Infections and Tumors of the Spine Infections of the Spine Spinal Anatomy Pyogenic Vertebral Osteomyelitis and Discitis Clinical Presentation Laboratory Studies Imaging Techniques Radiography Computed Tomography Magnetic Resonance Imaging Radionuclide Scanning Diagnostic Biopsy Differential Diagnosis Nonoperative Treatment Prognosis Operative Treatment Specific Infections Infections in Children Spinal Epidural Abscess (SEA) Surgical Site Infections Brucellosis Fungal Infections Tuberculosis Treatment of Thoracic and Lumbar Tubercular Spinal Infection Treatment of Cervical Tubercular Spinal Infections Atypical Tubercular Infections Abscess Drainage By Anatomic Level Cervical Spine Dorsal Spine Lumbar Spine Pelvis Psoas Abscess Tumors of the Spine Benign Tumors Stability Classification and Adjuvant Treatments Posterior Element Tumors Osteoid Osteoma Osteoblastoma Osteochondroma Aneurysmal Bone Cyst Vertebral Body Tumors Hemangioma Eosinophilic Granuloma Giant Cell Tumor Primary Malignant Tumors Classification Osteosarcoma Ewing Sarcoma Chordoma Multiple Myeloma Metastatic Tumors Classification Operative Treatment References Supplemental References Chapter 43: Pediatric Cervical Spine Normal Embryology and Growth and Development Anomalies of the Odontoid Diagnosis Radiographic findings Treatment Posterior cervical approaches Anterior cervical approaches Halo vest immobilization Basilar Impression Radiographic findings Treatment Atlantooccipital Fusion Radiographic findings Treatment Idiopathic Atlantooccipital Instability Klippel-Feil Syndrome Associated conditions Scoliosis Renal anomalies Cardiovascular anomalies Deafness Synkinesis Respiratory anomalies Sprengel deformity Cervical ribs Clinical findings Radiographic findings Treatment Atlantoaxial Rotatory Subluxation Radiographic findings Treatment Cervical Instability in Down Syndrome Neurologic findings Radiographic findings Treatment Familial Cervical Dysplasia Congenital Anomalies of the Atlas Larsen Syndrome Intervertebral Disc Calcification References Supplemental References Chapter 44: Scoliosis and Kyphosis Scoliosis Infantile Idiopathic Scoliosis Treatment Casting Operative treatment Juvenile Idiopathic Scoliosis Treatment Growing rod instrumentation Guided growth and physeal stapling Instrumentation with fusion Adolescent Idiopathic Scoliosis Etiology Natural history Patient evaluation Radiographic evaluation Measurement of curves Vertebral rotation Sagittal balance Curve patterns Lenke Classification Nonoperative treatment Observation Orthotic treatment Operative treatment Preoperative preparation Intraoperative considerations Surgical goals Posterior arthrodesis Bone grafting Complications of bone grafting Posterior spinal instrumentation Correction maneuvers Segmental instrumentation: pedicle screws Pedicle fixation Insertion of lumbar pedicle screws Insertion of thoracic pedicle screws Fusion levels and screw placement Hook site preparation and placement Sublaminar Cables/Bands Complications and pitfalls in segmental instrumentation systems Management of rigid curves Complications of posterior scoliosis surgery Early complications Neurologic Injury Infection Ileus Superior Mesenteric Artery Syndrome Atelectasis Pneumothorax Dural Tear Wrong Levels Urinary Complications Vision Loss Late complications Pseudarthrosis Crankshaft Phenomenon Posterior thoracoplasty Concave rib osteotomies Anterior instrumentation for idiopathic scoliosis Complications and pitfalls of anterior instrumentation Video-assisted thoracoscopy Pitfalls and complications Endoscopic anterior instrumentation of idiopathic scoliosis Neuromuscular Scoliosis Nonoperative treatment Observation Orthotic treatment Operative treatment Preoperative considerations Operative considerations Postoperative considerations Luque rod instrumentation with sublaminar wiring Sacropelvic fixation S2 iliac lumbopelvic screw placement Cerebral palsy Classification Nonoperative treatment Operative treatment Complications Friedreich ataxia Charcot-Marie-Tooth disease Syringomyelia Spinal cord injury Orthotic treatment Operative treatment Poliomyelitis Spinal muscular atrophy Orthotic treatment Operative treatment Familial dysautonomia Arthrogryposis multiplex congenita Duchenne muscular dystrophy Variants of muscular dystrophy other than Duchenne type Congenital Scoliosis Classification Patient evaluation Natural history Nonoperative treatment Operative treatment Posterior fusion without instrumentation Posterior fusion with instrumentation Combined anterior and posterior fusions Combined anterior and posterior convex hemiepiphysiodesis (growth arrest) Hemivertebra excision Thoracic insufficiency syndrome Kyphosis Scheuermann Disease Classification Etiology Clinical findings Radiographic findings Natural history Associated conditions Differential diagnosis Treatment Nonoperative treatment Observation Orthotic Treatment Operative treatment Complications Congenital Kyphosis Clinical and radiographic evaluation Operative treatment Treatment of type I deformity Treatment of type Ii deformity Complications of operative treatment Progressive Anterior Vertebral Fusion Infantile Lumbar Hypoplasia Spondylolysis and Spondylolisthesis Classification Etiology and natural history Clinical findings Radiographic findings Treatment of acquired spondylolysis Repair of spondylolytic defect Posterolateral fusion Treatment of developmental spondylolisthesis Nonoperative treatment Operative treatment Treatment of severe (high dysplastic) spondylolisthesis Treatment of spondyloptosis Kyphoscoliosis Myelomeningocele Incidence and natural history Clinical evaluation Radiographic findings Scoliosis and lordosis in myelomeningocele Orthotic Treatment Operative Treatment Combined anterior and posterior fusion Kyphosis in myelomeningocele Incidence and Natural History Operative Treatment Sacral agenesis Treatment Unusual Causes of Scoliosis Neurofibromatosis Management of nondystrophic curves Management of dystrophic scoliosis Scoliosis without kyphosis Kyphoscoliosis Kyphoscoliosis with spinal cord compression Postoperative management Complications of surgery Marfan syndrome Diagnosis Nonoperative treatment Observation Orthotic Treatment Operative treatment Vertebral column tumors Clinical findings Radiographic evaluation and treatment Biopsy Benign tumors of the vertebral column Osteoid Osteoma Osteoblastoma Aneurysmal Bone Cysts Eosinophilic Granuloma Hemangioma Primary malignant tumors of the vertebral column Ewing Sarcoma Osteogenic Sarcoma Postirradiation spinal deformity Incidence Radiographic findings Treatment Complications and pitfalls Osteochondrodystrophy Diastrophic dwarfism Spondyloepiphyseal dysplasia Osteogenesis imperfecta Anesthesia problems Orthotic treatment Operative treatment Unusual Causes of Kyphosis Postlaminectomy spinal deformity Treatment Skeletal dysplasias Achondroplasia Mucopolysaccharidoses References Supplemental References Part XIII: Sports Medicine Chapter 45: Knee Injuries Anatomy Osseous Structures Extraarticular Tendinous Structures Extraarticular Ligamentous Structures Medial Side Anatomy Medial Collateral Ligament Midmedial Capsule Posteromedial Corner Lateral Collateral Ligament Iliotibial Band Popliteal Tendon Lateral Side Anatomy Anterolateral Ligament Popliteus Muscle and Ligament Intraarticular Structures Mechanics Menisci Function and Anatomy Meniscal Healing and Repair Mechanism of Tear Classification of Meniscal Tears Diagnosis Diagnostic Tests Imaging Studies Radiography Arthrography Other Diagnostic Studies Arthroscopy Nonoperative Management Operative Management Late Changes After Meniscectomy Surgical Repair of Torn Menisci Meniscal Autografts and Allografts Other Conditions of Menisci Cysts of Menisci Discoid Meniscus Treatment Acute Traumatic Lesions of Ligaments General Considerations Etiology Mechanism Ligament Healing Classification Diagnosis History and Physical Examination Standard Stress Tests Rotary Tests Radiographic Examination Classification of Knee Instability One-Plane Instability Rotary Instability Combined Instabilities Treatment Considerations Nonoperative Treatment Operative Treatment Medial Compartment (Collateral) Disruptions Repair Reconstruction Reconstruction With Allograft Tendons Lateral Compartment (Collateral) Disruptions Reconstruction of Lateral Compartment Posterolateral Rotary Instability Posterolateral Instability With Varus Knee Anterolateral Rotary Instability Anterior Cruciate Ligament Injuries Incidence Anatomy Biomechanics History and Physical Examination Natural History Treatment Reconstruction for Anterior Cruciate Ligament Insufficiency Intraarticular Reconstruction Reconstruction With Hamstring Tendons Combined Anterior Cruciate Ligament Instabilities Synthetic Materials for Ligament Reconstruction Allograft Ligament Replacement Rehabilitation After Anterior Cruciate Ligament Reconstruction Results of Anterior Cruciate Ligament Reconstruction Complications of Anterior Cruciate Ligament Surgery Revision Anterior Cruciate Ligament Surgery Graft Selection Technical Considerations Posterior Cruciate Ligament Anatomy Biomechanics Physical Examination Natural History Treatment Nonoperative Treatment Operative Treatment Reconstruction of Posterior Cruciate Ligament Reconstruction of Posterior Cruciate Ligament With Bone–Patellar Tendon–Bone or Achilles Tendon–Bone Grafts Arthroscopically Aided Posterior Cruciate Ligament Reconstruction Complications of Posterior Cruciate Ligament Reconstruction Traumatic Dislocations Classification Examination and Radiographic Evaluation Vascular and Nerve Injuries Vascular Injuries Nerve Damage Other Associated Injuries Treatment Outcome of Operative Treatment of Knee Dislocations Synovial Plicae Articular Cartilage Injuries Treatment Arthroscopic Debridement Abrasion Chondroplasty, Microfracture Osteochondral Autograft Transplant, Osteochondral Allografting, Autologous Chondrocyte Implantation Autologous Chondrocyte Implantation Emerging Technologies Osteochondritis Dissecans Etiology Clinical and Radiographic Findings Treatment Excision of Loose Bodies Fixation of Fragments Drilling of the Lesion Outcomes of Treatment of Osteochondritis Dissecans of the Knee Complications Disorders of the Patella Osteochondritis Dissecans of the Patella Dorsal Defect of the Patella Bipartite Patella Chondromalacia of the Patella Classification and Etiology Clinical Findings Treatment Extraarticular Ankylosis of the Knee Extraarticular Ankylosis in Extension Extraarticular Ankylosis in Flexion Open Wounds of the Knee Joint References Supplemental References Chapter 46: Shoulder and Elbow Injuries Shoulder Injuries Anatomy and Biomechanics Clinical Presentation and Physical Examination Neer Impingement Sign and Impingement Test Hawkins-Kennedy Test Jobe Test Internal Rotation Resistance Stress Test Active Compression Test Dynamic Labral Shear Test Kim Test for Posteroinferior Labral Tear Jerk Test for Posterior Labral Lesions Biceps Load II Test for Isolated Slap Lesions Gerber Subcoracoid Impingement Test Jobe Apprehension-Relocation Test Speed Test Yergason Sign Lift-Off Test Belly Press Test Bear-Hug Test for Subscapularis Tear External Rotation Stress Test External Rotation Lag Sign Patte (Hornblower) Sign Drop Sign Internal Rotation Lag Sign Imaging Impingement Syndrome Subcoracoid Impingement Internal Impingement Primary (External) Impingement Complications Rotator Cuff Tear Partial-Thickness and Full-Thickness Tears Massive and Irreparable Tears Complications Cuff Tear Arthropathy Adhesive Capsulitis Primary Frozen Shoulder Treatment Complications Calcific Tendinitis Chronologic Progression Percutaneous and Surgical Treatment Quadrilateral Space Syndrome Suprascapular Nerve Entrapment Elbow Injuries Elbow Tenopathies Lateral Epicondylitis (Tennis Elbow) Treatment Medial Epicondylitis Elbow Contractures Heterotopic Ossification References Supplemental References Chapter 47: Recurrent Dislocations Patella Clinical Features Radiographic Features Conservative Treatment Acute Patellar Dislocation or Subluxation Surgical Treatment of Patellar Instability Iatrogenic Medial Patellar Instability Hip Sternoclavicular Joint Shoulder Normal Functional Anatomy Pathologic Anatomy Classification History Physical Examination Radiographic Evaluation Examination Using Anesthetic and Arthroscopy Anterior Instability of the Shoulder Surgical Treatment Unsuccessful Surgical Repairs for Anterior Instability Multidirectional Instability of the Shoulder Capsular Shift With Incision Adjacent to the Glenoid Hill-Sachs Lesions Posterior Instability of the Shoulder Conservative Treatment Surgical Treatment Surgical Failures Arthroscopic Surgery Elbow Anatomy Pathophysiology Physical Examination Nonoperative Treatment Arthroscopy Surgical Treatment References Supplemental References Chapter 48: Traumatic Disorders Compartment Syndrome Anatomy and Pathophysiology Acute Compartment Syndrome Clinical Evaluation Treatment Acute Compartment Syndrome of Thigh Acute Compartment Syndrome of Lower Leg Chronic Exertional Compartment Syndrome Clinical Evaluation Treatment Nonoperative Treatment Operative Treatment Rupture of Muscles and Tendons Rupture of Achilles Tendon Anatomy and Pathophysiology Clinical Evaluation Treatment Acute Rupture Open Repair Techniques For Achilles Tendon Rupture Chronic Rupture Complications Rupture of Gastrocnemius Muscle Tendinosis of Extensor Mechanism of Knee (Jumper’s Knee) Chronic Patellar Tendinosis Stress Fracture Through The Patella Rupture of Extensor Mechanism of Knee Anatomy and Pathophysiology Clinical Evaluation Treatment of Acute Rupture of Patellar Tendon Treatment of Chronic Rupture of Patellar Tendon Rupture of Tendon of Quadriceps Femoris Muscle Acute Rupture Chronic Rupture Complications Rupture of Adductor Longus Muscle Rupture of Gluteus Medius and Minimus Tendons Hamstring Tendon Injuries Treatment Nonoperative Treatment Operative Treatment Complications Rupture of Biceps Brachii Tendons Proximal Biceps Tendon Rupture Distal Biceps Tendon Rupture Rupture of Pectoralis Major Muscle Rupture or Avulsion of Triceps Tendon Displacement of Tendons Peroneal Tendons Classification Clinical and Radiographic Evaluation Treatment Complications Biceps Brachii Tendon Clinical Evaluation Treatment References Supplemental References Part XIV: Arthroscopy Chapter 49: General Principles of Arthroscopy Instruments and Equipment Arthroscope Television Cameras Accessory Instruments Probe Scissors Basket Forceps Grasping Forceps Knife Blades Motorized Shaving Systems Electrosurgical, Laser, and Radiofrequency Instruments Implants Miscellaneous Equipment Care and Sterilization of Instruments Irrigation Systems Tourniquet Leg Holders Anesthesia Documentation Advantages Disadvantages Indications and Contraindications Basic Arthroscopic Techniques Triangulation Technique Complications Damage to Intraarticular Structures Damage to Menisci and Fat Pad Damage to Cruciate Ligaments Damage to Extraarticular Structures Blood Vessels Compartment Syndromes Nerves Ligaments and Tendons Hemarthrosis Thrombophlebitis Infection Tourniquet Paresis Synovial Herniation and Fistulas Instrument Breakage Implant Complications References Supplemental References Chapter 50: Arthroscopy of the Foot and Ankle Ankle Arthroscopy Complications Ankle Impingement Syndromes Anterior Ankle Impingement Outcomes Posterior Ankle Impingement Outcomes Anterior and Posterior Impingement Osteochondral Lesions of the Talus Ankle Fractures Tillaux Fractures Calcaneal Fractures Ankle Arthrodesis Ankle Instability Other Indications Septic Arthritis Arthrofibrosis Subtalar Arthroscopy First Metatarsophalangeal Joint Arthroscopy Tendoscopy/Endoscopy of Tendons References Supplemental References Chapter 51: Arthroscopy of the Lower Extremity Knee Basic diagnostic techniques General principles Patient positioning Portal placement Standard portals Optional Portals Insertion of scope Arthroscopic examination of the knee Arthroscopic surgery of the meniscus Classification of meniscal tears Types of meniscal excisions Partial Meniscectomy Subtotal Meniscectomy General principles Surgery for specific meniscal tears Vertical Longitudinal (Bucket-Handle) Tears Longitudinal Incomplete Intrameniscal Tears Horizontal, Oblique, Radial, and Complex Tears Discoid Lateral Meniscus Meniscal cyst Arthroscopic repair of torn menisci Hidden Lesions: Rips, Ramps, and Roots Radial tears and meniscal root tears All-Inside Technique Biologics for Healing Meniscal replacement Arthroscopic surgery for other disorders Loose bodies in the knee joint Synovial plicae of the knee Osteochondritis dissecans and chondral defects of the femoral condyles and patella Osteochondritic Loose Bodies Osteochondral Autografts Bone Grafting Cruciate ligament reconstruction Anterior Cruciate Ligament Reconstruction Complications of Anterior Cruciate Ligament Reconstruction Posterior Cruciate Ligament Reconstruction Chondromalacia of the patella syndrome Arthroscopic Medial Parapatellar Plication Other applications of arthroscopy of the knee Arthroscopy in fractures around the knee Arthrofibrosis Complications associated with knee arthroscopy Hip Indications/contraindications General setup Portals Hip capsule Arthroscopic management of labral tears Femoroacetabular impingement Labral Reconstruction Abductor Tendon Tears Snapping hips Revision Hip Arthroscopy Complications of hip arthroscopy References Supplemental References Chapter 52: Arthroscopy of the Upper Extremity Shoulder Indications Patient Positioning and Anesthesia Lateral Decubitus Position Beach-Chair Position Control of Bleeding During Arthroscopy Fluid Extravasation Portal Placement Posterior Portal Posteroinferior Seven-O’clock Portal Anterior Portal Anteroinferior Five-O’clock Portal (Used With Caution) Superior Portal Suprascapular Nerve Portal As Described By Lafosse Lateral, Posterolateral, and Anterolateral Portals Portal of Wilmington Diagnostic Arthroscopy and Arthroscopic Anatomy Loose Bodies Synovectomy Drainage and Debridement Labral Tears Biceps Tendon Lesions Subpectoral Biceps Tenodesis Anterior Instability Arthroscopic Bankart-Bristow-Latarjet Technique Posterior Instability Multidirectional Instability Humeral and/or Glenoid Avulsion of the Inferior Glenohumeral Ligament Hill-Sachs Lesion Bony Bankart Lesions and Glenoid Fractures Latarjet Procedure Subacromial Impingement Syndrome Partial-Thickness Rotator Cuff Tears Full-Thickness Rotator Cuff Tears Massive Contracted Rotator Cuff Tears Subscapularis Tendon Tears Acromioclavicular Joint Osteoarthritis Acromioclavicular Joint Separation Calcific Tendinitis of the Rotator Cuff Osteoarthritis Posterior Ossification of the Shoulder (Bennett Lesion) Spinoglenoid Cyst Shoulder Contractures Suprascapular Nerve Entrapment Complications Elbow Indications Patient Positioning and Anesthesia Supine Position Prone Position Lateral Decubitus Position Portal Placement Evaluation of the Elbow Loose Bodies Panner Disease and Osteochondritis Dissecans Throwing Injuries Evaluation of Ulnar Collateral Ligament Function Posterior Elbow Impingement Posterolateral Synovial Plica Syndrome Radial Head Resection Arthrofibrosis Osteoarthritis Synovectomy Tennis Elbow Olecranon Bursitis Arthroscopic-Assisted Intraarticular Fracture Care Pyarthrosis Complications Wrist References Supplemental References Part XV: Fractures and Dislocations in Adults Chapter 53: General Principles of Fracture Treatment Classification of Fractures Classification of Soft-Tissue Injuries Trauma Principles Open Fractures Open Fractures Caused by Firearms Amputation Versus Limb Salvage Antibiotic Treatment Treatment of Soft-Tissue Injuries Debridement Treatment of Bone Injuries Fracture Stabilization Fracture Healing (Bone Regeneration) Stimulation of Fracture Healing Bone Grafting Autologous Bone Grafts Bone Graft Substitutes Allograft-Based Bone Graft Substitutes Growth Factor–Based Bone Graft Substitutes Cell-Based Bone Graft Substitutes Ceramic-Based Bone Graft Substitutes Polymer-Based Bone Graft Substitutes Miscellaneous Bone Graft Substitutes Electrical and Ultrasound Stimulation Factors That Negatively Affect Bone Healing Principles of Surgical Treatment General Indications for Surgical Reduction and Stabilization Contraindications to Surgical Reduction and Stabilization Disadvantages of Surgical Reduction and Stabilization Timing of Surgical Treatment Lambotte’s Principles of Surgical Treatment of Fractures Biomaterials of Fracture Fixation Metals Bioabsorbable Materials Complications Biomechanics of Implant Design and Fracture Fixation Pin and Wire Fixation Screw Fixation Machine Screws Internal Fixation Screws Cortical Screws Cancellous Screws Self-Tapping, Self-Drilling Screws Locking Screws Screws Fixation Techniques Plate and Screw Fixation Locking Plates Intramedullary Nail Fixation Types of Intramedullary Nails Reamed Versus Unreamed Intramedullary Nailing External Fixation Advantages Disadvantages Complications Pin Track Infection Neurovascular Impalement Muscle or Tendon Impalement Delayed Union Compartment Syndrome Refracture Limitation of Future Alternatives Indications Accepted Indications Possible Indications Fixation of Multiple Closed Fractures Severely Comminuted Fractures Ligamentotaxis Fixation of Fractures in Patients With Head Injuries Fixation of Fractures in Patients who Require Frequent Transportation for Diagnostic Testing, Therapy, or Other Surgical Procedures Fixation of Floating Knee Fractures Assessment of Knee Ligament Stability With Fractures of the Upper Tibia or Lower Femur in Patients in Whom Integrity of Knee Ligaments is Difficult to Assess Occasional Indications Design and Application of External Fixators General Method for Half-Pin Fixators General Method for Circular Wire Fixators Ilizarov External Fixator Rehabilitation Treatment of Complications From Surgical Treatment of Fractures Infection Gas Gangrene Tetanus Soft-Tissue Complications Thromboembolic Complications Biomechanical Construct Complications References Supplemental References Chapter 54: Fractures of the Lower Extremity Ankle Classification Isolated Fractures of the Medial and Lateral Malleoli Medial Malleolar Fracture Stress Fracture of the Medial Malleolus Lateral Malleolar Fracture Bimalleolar Fracture Syndesmotic Injury Deltoid Ligament Tear and Lateral Malleolar Fracture Irreducible Fracture or Fracture-Dislocation Trimalleolar Fracture Posterior Tibial Lip Fracture Fracture of the Anterior Tibial Margin at the Ankle Joint Ankle Fractures in Patients With Diabetes Open Ankle Fractures Unstable Ankle Fracture-Dislocation Tibial Pilon Fracture Open Reduction and Plate Fixation Two-Stage Delayed Open Reduction and Internal Fixation Plating Technique Minimally Invasive Plating Posterolateral Approach to Pilon Fractures Combined Internal and External Fixation External Fixation and Fibular Plating Spanning External Fixation Hybrid External Fixation Primary Arthrodesis Fractures of the Tibial Shaft Treatment Cast Bracing Plate and Screw Fixation Transfixation by Screws Intramedullary Fixation Reamed Versus Unreamed Nailing Intramedullary Nailing of Fractures of the Proximal Third of the Tibial Shaft Intramedullary Nailing of Fractures of the Distal Tibial Shaft Anterior Knee Pain After Intramedullary Nailing Intramedullary Interlocking Nails Preoperative Planning External Fixation Half-Pin Fixators Preoperative Planning Complications Ilizarov External Fixation Device Ilizarov Method in Open Fractures Reconstructive Procedures Preoperative Planning Complications Treatment of Delayed Union or Nonunion Fixation of the Fibula for Tibial Fracture Deformities of the Foot and Toes After Tibial Fracture Tibial Plateau Fracture Fracture Classification Fracture-Dislocation Classification Evaluation Treatment Fracture of the Lateral Condyle Ligament Injury With Condylar Fracture Arthroscopically Assisted Reduction and Fixation of Tibial Plateau Fractures Fracture of the Medial Condyle Comminuted Proximal Fractures Patella Treatment Comminuted Patellar Fractures Distal Femur Plate and Screw Fixation Dynamic Condylar Screw Fixation Intramedullary Nailing External Fixation Condylar Fractures of the Femur Unicondylar Fractures of the Femur Intercondylar Fractures of the Femur Locking Condylar Plate Fixation Less Invasive Stabilization System Supracondylar Fractures of the Femur Shaft of the Femur Traction and Cast Immobilization External Fixation Fixation With Plates and Screws Intramedullary Fixation Preoperative Planning Retrograde Nailing of the Femur Errors and Complications of Intramedullary Fixation Patient Positioning and Traction Errors in Nail Insertion Bent or Broken Nails Infections Intramedullary Fixation in Pathologic Fractures Fracture of the Femoral Shaft With Dislocation of the Hip References Supplemental References Chapter 55: Fractures and Dislocations of the Hip Femoral Neck Fractures Classification Diagnosis Treatment Operative Treatment Implant Choice Outcomes and Complications Failure of Fixation Nonunion and Osteonecrosis Arthroplasty Basicervical Femoral Neck Fractures Intertrochanteric Femoral Fractures Classification Treatment Treatment With Screw–Side Plate Devices Treatment With Intramedullary Nails Short or Long Nails for Intertrochanteric Femoral Fractures Plate Fixation Compared With Intramedullary Nail Fixation Subtrochanteric Femoral Fractures Classification Treatment Intramedullary Nailing Plate Fixation Hip Dislocations and Femoral Head Fractures Reduction Maneuvers for Posterior Hip Dislocation Reduction Maneuver for Anterior Hip Dislocation Fractures of the Ipsilateral Femoral Neck and Shaft References Supplemental References Chapter 56: Fractures of the Acetabulum and Pelvis Acetabular Fractures Anatomy Radiographic Evaluation Classification Treatment Initial Treatment Indications for Nonoperative Treatment Nondisplaced and Minimally Displaced Fractures Fractures With Significant Displacement but in Which the Region of the Joint Involved is Judged to be Unimportant Prognostically Secondary Congruence in Displaced Both-Column Fractures Medical Contraindications to Surgery Local Soft-Tissue Problems, Such as Infection, Wounds, and Soft-Tissue Lesions From Blunt Trauma Elderly Patients With Osteoporotic Bone Indications for Operative Treatment Fracture Characteristics Incarcerated Fragments in the Acetabulum After Closed Reduction of a Hip Dislocation Prevention of Nonunion and Retention of Sufficient Bone Stock for Later Reconstructive Surgery Timing of Surgery Choice of Surgical Approach Specific Fracture Patterns Posterior Wall Fractures Posterior Column Fractures Anterior Wall and Anterior Column Fractures Transverse Fractures Posterior Column Fracture With Associated Posterior Wall Fracture Transverse Fracture With Associated Posterior Wall Fracture T-Shaped Fractures Anterior Column–Posterior Hemitransverse Fractures Associated Both-Column Fractures Postoperative Care Outcome and Complications Acute Total Hip Arthroplasty as Treatment of Acetabular Fracture Complications of Acute Total Hip Arthroplasty for Acetabular Fracture Total Hip Arthroplasty for Posttraumatic Arthritis Pelvic Fractures Anatomy Radiographic Evaluation Classification Treatment Initial Management Indications for Nonoperative and Operative Treatment Timing of Surgery Choice of Treatment External Fixation Internal Fixation of the Anterior Pelvis Posterior Approach and Internal Fixation Percutaneous Iliosacral Screw Fixation of Sacroiliac Disruptions and Sacral Fractures (Supine) Outcomes References Supplemental References Chapter 57: Fractures of the Shoulder, Arm, and Forearm Clavicle Treatment options Plate and screw fixation Intramedullary fixation Lateral clavicular fractures Fractures Around The Shoulder Fractures of the scapula Treatment options Glenoid fractures Scapular body or neck fractures Proximal humeral fractures Classification Radiographic evaluation Nonoperative treatment Operative treatment Fixation of specific fracture types Complications Fractures of the Humeral Shaft Indications for operative treatment Plate osteosynthesis Implant choice Approach Postoperative care Complications Intramedullary fixation Fractures of the Humeral Shaft With Radial Nerve Palsy Periprosthetic humeral shaft fractures Distal humeral fractures Fractures, Dislocations, and Fracture-Dislocations of the Elbow Fractures of the radial head Operative treatment Treatment of mason type II Fractures Treatment of Mason Type III Fractures Fractures of the coronoid Simple elbow dislocations Fracture-dislocations of the elbow Treatment “Terrible triad” injuries of the elbow Treatment Complications Radial head and neck fractures associated with elbow dislocation Fractures and fracture-dislocations of the olecranon Fractures Treatment Fracture-Dislocations Fractures of the radial head or neck with dislocation of the distal radioulnar joint (essex-lopresti fracture-dislocation) Fractures of the proximal third of the ulna with dislocation of the radial head (monteggia fracture-dislocation) Fractures of the Shafts of the Radius and Ulna Fractures of the distal third of the radius with dislocation of the distal radioulnar joint (galeazzi fracture-dislocation) Fractures of the Distal Radius Classification Assessment of stability Treatment options Closed treatment Percutaneous pinning External Fixation Open reduction and plate fixation Dorsal Plating Volar Plating Fragment-Specific Open Reduction and Internal Fixation of Comminuted Distal Radial Fractures Complications References Supplemental References Chapter 58: Malunited Fractures Foot Phalanges of the Toes Metatarsals Tarsals Talus Malunion of the Talar Neck Malunion of the Talar Body Calcaneus Ankle Arthrodesis for Malunited Fractures of the Ankle Tibia Shafts of the Tibia and Fibula Condyles of the Tibia Inverted-Y Fractures of the Tibial Condyles Fracture of the Intercondylar Eminence of the Tibia Patella Femur and Hip Condyles of the Femur Lateral Femoral Condyle Medial Femoral Condyle Both Femoral Condyles Supracondylar Femur Femoral Shaft Femoral Malunion in Children Trochanteric Region of the Femur Subtrochanteric Osteotomy for Coxa Vara and Rotational Deformities Cervicotrochanteric Region of the Femur Acetabulum Pelvis Three-Stage Reconstruction for Pelvic Malunions Scapula Clavicle Midshaft Malunions of the Clavicle Humerus Proximal Humerus Evaluation Treatment Acromioplasty and Osteotomy Arthroplasty Humeral Shaft Middle Third Distal Humerus Forearm Proximal Third of the Radius and Ulna Radial Head Radial Neck Olecranon Proximal Third of the Ulna with Anterior Dislocation of the Radial Head (Monteggia Fracture) Synostosis Between the Radius and the Ulna Shafts of the Radius and Ulna in Adults Forearm Malunions with Distal Radioulnar Joint Instability Shaft of the Ulna Distal Radius Clinical Evaluation Radiographic Evaluation Operative Treatment Extraarticular Malunion with Dorsal Angulation Osteotomy and Grafting of the Radius Extraarticular Malunion with Volar Angulation Intraarticular Malunions Salvage Procedures Distal Radioulnar Joint Incongruity and Arthrosis Carpus Hand References Supplemental References Chapter 59: Delayed Union and Nonunion of Fractures Definitions Delayed union Nonunion Etiology and Pathophysiology General Treatment of Nonunions Preoperative workup Considerations before surgery Status of soft tissues and neurovascular structures Status of bones Reduction and preparation of nonunions Bone grafting Ceramics Stabilization of fragments Plating Intramedullary nailing External fixation Arthroplasty Amputation Low-intensity ultrasound Electrical and electromagnetic stimulation Extracorporeal shock-wave therapy Factors Complicating Nonunion Infection Conventional treatment Active treatment Polymethyl methacrylate antibiotic Beads Deformity, shortening, and segmental Bone loss Ilizarov method Taylor spatial frame method Corticotomy Nonunion of Specific Bones Tibia Medial malleolus Tibial shaft Role of the Fibula in Tibial Nonunion Treatment Internal fixation Plate Fixation External fixation Distal tibia Fibula Lateral malleolus Fibular shaft Patella Femur Supracondylar area Femoral shaft Peritrochanteric and subtrochanteric region Femoral neck Osteotomy Prosthetic Replacement Arthrodesis Pelvis and acetabulum Clavicle Humerus Proximal third Humeral shaft Distal humerus Proximal third of the ulna with dislocation of the radial head Forearm bones Both radius and ulna Radius or ulna alone Distal End of the Radius Proximal end of ulna Distal end of ulna References Supplemental References Chapter 60: Acute Dislocations Indications for Open Ankle Ankle Patella Acute Dislocations of the Patella Intraarticular Dislocations of the Patella Knee Proximal Tibiofibular Joint Hip Complications Pubic Symphysis and Sacroiliac Joints Sternoclavicular Joint Acromioclavicular Joint Etiology and Classification Clinical Findings Treatment Shoulder Elbow Dislocation of The Radial Head Dislocation of Radial Head and Fracture of Proximal Third of Ulna (Monteggia Fracture) Fracture-Dislocation of Elbow with Severe Damage of Soft Structures Distal Radioulnar Joint References Supplemental References Chapter 61: Old Unreduced Dislocations Foot Ankle Proximal Tibiofibular Joint Knee Patella Hip Chronic Anterior Dislocations Chronic Posterior Dislocations Sternoclavicular Joint Posterior Dislocations Acromioclavicular Joint Shoulder Treatment Closed Reduction Open Reduction Anterior Dislocations Posterior Dislocations Hemiarthroplasty Total Shoulder Arthroplasty Elbow Closed Reduction Open Reduction Elbow Arthroplasty Anterior Dislocation of the Radial Head References Supplemental References Part XVI: Peripheral Nerve Injuries of the Upper and Lower Extremities Chapter 62: Peripheral Nerve Injuries Anatomy of the Spinal Nerves Components of Mixed Spinal Nerves Motor Sensory Sympathetic Gross Anatomy Microscopic Anatomy Internal Topography of Peripheral Nerves Neuronal Degeneration and Regeneration Classification of Nerve Injuries Effects of Peripheral Nerve Injuries Motor Sensory Reflex Autonomic Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy) Clinical Presentation Treatment Etiology of Peripheral Nerve Injuries Clinical Diagnosis of Nerve Injuries Diagnostic Tests Imaging Electrodiagnostic Studies Nerve Conduction Velocity Electromyography Tinel Sign Sweat Test Skin Resistance Test Electrical Stimulation General Considerations of Treatment of Nerve Injuries Factors That Influence Regeneration After Neurorrhaphy Age Gap Between Nerve Ends Delay Between Time of Injury And Repair Level of Injury Condition of Nerve Ends General Considerations for Surgery Indications Time of Surgery Instruments and Equipment Anesthesia Preparation and Draping Technique of Nerve Repair Endoneurolysis (Internal Neurolysis) Partial Neurorrhaphy Neurorrhaphy and Nerve Grafting Methods of Closing Gaps Between Nerve Ends Mobilization Positioning of Extremity Transposition Bone Resection Nerve Grafting Nerve Crossing (Pedicle Grafting) Source of Nerve for Interfascicular Nerve Grafting Nerve Allografts Synthetic Nerve Conduits Techniques of Neurorrhaphy Results of Operation Cervical Plexus Spinal Accessory Nerve Treatment Results of Suture of the Spinal Accessory Nerve Nerve Transfers Upper Extremity Nerve Injuries Suprascapular Nerve Examination Treatment Long Thoracic Nerve Axillary Nerve Examination Treatment Methods of Closing Gaps Results After Axillary Nerve Injury Tendon and Muscle Transfers for Paralysis of the Deltoid Musculocutaneous Nerve Examination Treatment Methods of Closing Gaps Results After Injury to the Musculocutaneous Nerve Radial Nerve Examination Treatment Methods of Closing Gaps Results of Suture of the Radial Nerve Critical Limit of Delay of Suture Ulnar Nerve Examination Treatment Methods of Closing Gaps Results of Suture of the Ulnar Nerve Critical Limit of Delay of Suture Nerve Reconstruction Median Nerve Examination Treatment Methods of Closing Gaps Results of Suture of the Median Nerve Critical Limit of Delay of Suture Lumbar Plexus Femoral Nerve Examination Treatment Methods of Closing Gaps Results of Suture of the Femoral Nerve Sacral Plexus Sciatic Nerve Examination Treatment Methods of Closing Gaps Results of Suture of the Sciatic Nerve Critical Limit of Delay of Suture Common, Superficial, and Deep Peroneal Nerves Examination Treatment Methods of Closing Gaps Results of Suture of the Peroneal Nerve Critical Limit of Delay of Suture Tendon Transfer for Peroneal Nerve Paralysis Tibial Nerve Examination Treatment Approach to the Tibial Nerve in the Popliteal Fossa Methods of Closing Gaps Results of Suture of the Tibial Nerve References Supplemental References Part XVII: Microsurgery Chapter 63: Microsurgery Microvascular Techniques Replantation Results Replantation team General considerations Indications and contraindications Age Severity of injury Level of injury and part amputated Warm ischemia (anoxic) time Preexisting deformity or disability Conditions that might preclude replantation Management and transportation of patient and part Preoperative preparation Order of repair Management of bones and joints Transposition of digits Tendon repair Flexor tendons Extensor tendons Vessel repair Order of vessel repair Management of circulatory compromise after replantation Complications Rehabilitation Monitoring techniques after microvascular surgery Revascularization Special techniques Single-Stage Tissue Transfer (Free Flaps) Indications and advantages Contraindications and disadvantages Selection of free flaps Upper extremity Lower extremity Preoperative requirements General plan of procedure General postoperative care Monitoring Free groin flap Vascular anatomy Anterolateral thigh flap Vascular anatomy Scapular and parascapular flap Vascular anatomy Lateral arm flap Vascular anatomy Muscle and Musculocutaneous Free Flaps Latissimus dorsi transfer Vascular anatomy Serratus anterior flap Vascular anatomy Tensor fasciae latae muscle flap Vascular anatomy Gracilis muscle transfer Vascular anatomy Rectus abdominis transfer Vascular anatomy Functioning Neuromuscular Transfers Free Vascularized Bone Transplant Indications Preoperative planning Free vascularized fibular transfer Free vascularized medial femoral condyle flap Composite Free Tissue Transfers From the Foot Neurovascular anatomy Dorsalis pedis flap First web space, pulp, and hemipulp neurovascular free flaps Great toe wraparound flap Thumb and Finger Reconstruction Single-stage transfer of the great toe Indications Preoperative planning Second and third toe transplantation Preoperative preparation Vascularized Free Flaps Containing Joints and Epiphyses References Supplemental References Part XVIII: The Hand Chapter 64: Basic Surgical Technique and Postoperative Care Preoperative Planning and Preparation Perioperative Antibiotics Arrangement and Routine in the Operating Room Choice of Anesthesia Brachial plexus blocks Intravenous regional anesthesia Peripheral nerve blocks Digital nerve blocks Local infiltration WALANT approach WALANT Administration Preparation and Draping for Elective Surgery Tourniquet Instruments Basic Skin Technique Incisions Finger incisions Thumb incisions Palmar incisions Basic skin closure techniques Care After Surgery Splinting References Supplemental References Chapter 65: Acute Hand Injuries History Examination Splinting Anesthesia Tourniquet Cleansing and Draping of Hand Considerations for Amputation Order of Tissue Repair Arterial Injuries Considerations for Skin Closure Methods and Indications for Skin Closure Direct Suture Skin Grafts Skin Flaps Coverage of Specific Areas with Flaps Management of Donor Area Grafts and Flaps Free Grafts Split-Thickness Skin Grafts Obtaining Skin Grafts with A Dermatome Free Full-Thickness Grafts Skin Flaps Local Flaps Local Flaps in Fingers Local Flaps From the Dorsum of the Hand Cross Finger Flaps Forearm Flaps For Hand Coverage Radial Forearm Flap Posterior Interosseous Flap Abdominal Flaps Random Pattern Abdominal Pedicle Flaps Axial Pattern Flaps Filleted Grafts Skin Coverage Granulating Areas Scars Methods of Correcting Linear Scars Methods of Correcting Area Scars References Supplemental References Chapter 66: Flexor and Extensor Tendon Injuries Flexor Tendons Examination Basic tendon techniques Suture material Suture configurations End-to-End Suture Techniques Double Right-Angled Suture Fish-Mouth End-To-End Suture (Pulvertaft) Tendon-to-Bone Attachment Suture Anchor Tendon Attachment Timing of flexor tendon repair Partial flexor tendon lacerations Primary flexor tendon repair Zone I Zone II Zone III Zone IV Zone V Delayed repair of acute injuries Primary suture of flexor tendons Flexor Tendon Injuries In Children Flexor tendon ruptures Treatment Postrepair rupture Repair of flexor tendon of thumb Zone I Zone II Zone III Zone IV Zone V Secondary repair and reconstruction of flexor tendons Flexor tendons of fingers Zone I (Distal Half of Finger) Zone II (Critical Area of Pulleys) Zones III, IV, and V (Forearm and Palm) Donor tendons for grafting Palmaris Longus Plantaris Tendon Long Extensors of Toes Extensor Indicis Proprius, Extensor Digitorum Communis of Index Flexor Digitorum Sublimis Complications “Lumbrical Plus” Finger “Quadriga” Effect Reconstruction of flexor tendon pulleys Reconstruction of finger flexors by two-stage tendon graft Long Flexor of Thumb Flexor tenolysis after repair and grafting Adherence of tendons Adherence of a Tendon to a Fracture Site Extensor Tendons Anatomy Examination Extensor tendon repair Zone I Extensor Tendon Rupture Acute Transection of Extensor Tendon Correction of an old Mallet Finger Deformity by Tendon Transfer or Tendon Graft Zone II Zone III Rupture or Acute Transection of the Central Slip of the Extensor Expansion (Boutonniere Deformity) Chronic Boutonniere Deformity (Secondary Repair and Reconstruction) Zone IV Zone V Traumatic Dislocation of the Extensor Tendon at the Metacarpophalangeal Joint Zone VI Zone VII Zone VIII Zone IX Secondary repair of extensor tendons Extensors of the thumb Zones TI and TII Zones TIII and TIV Zone TV References Supplemental References Chapter 67: Fractures, Dislocations, and Ligamentous Injuries of The Hand and Wrist Principles of Treatment Open Fractures and Dislocations Basic Fracture Techniques Thumb Bennett Fracture Complications Rolando Fracture (Comminuted First Metacarpal Base) and Other Fractures Involving the First Carpometacarpal Joint Thumb Carpometacarpal Joint Dislocation Thumb Metacarpophalangeal Fractures and Dislocations Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Rupture Chronic Ulnar Collateral Ligament Reconstruction Radial Collateral Ligament Injuries Finger Metacarpals Carpometacarpal Fracture-Dislocations Intraarticular Fracture of the Fifth Metacarpal Base Finger Metacarpophalangeal Dislocations Metacarpal Shaft or Neck Fractures Metacarpal Head Fractures Minicondylar Plate Fixation Wiring Techniques Phalanges Fracture of The Middle or Proximal Phalanx Proximal Interphalangeal Joint Fracture-Dislocation Closed Reduction and Extension Block Splinting Dynamic External Splint Reduction Interphalangeal Dislocations Unstable Proximal Interphalangeal Joint Secondary to Chronic Collateral Ligament Rupture Undiagnosed Interphalangeal Dislocations Distal Phalangeal Fractures Mallet Finger Intraarticular Fractures Complications of Hand Fractures Malunion Nonunion Contracture References Supplemental References Chapter 68: Nerve Injuries at the Level of the Hand and Wrist Evaluation Preoperative Assessment Type of Injury Sensibility Evaluation Motor Function Sudomotor Function Postoperative Assessment Sensibility Evaluation Motor Function Subjective Evaluation Sudomotor Function Nerve Regeneration Primary and Delayed Primary Nerve Repair Timing of Repair Indications Secondary Nerve Repair Indications Suturing of Nerves Nerve Grafts Indications Sources of Nerve Grafts Alternative Nerve Graft Material Management of Specific Nerve Injuries Digital Nerves Nerve Transfers to Restore Digital Sensation Ulnar Nerve at the Wrist Deep Branch of the Ulnar Nerve Dorsal Branch of the Ulnar Nerve Median Nerve at the Wrist Median Nerve in the Palm Superficial Radial Nerve Traumatic Neuromas Neurovascular Island Grafts References Supplemental References Chapter 69: Wrist Disorders Anatomy Circulation Biomechanics and kinematics Diagnosis of Wrist Conditions History Physical examination Radiographic techniques Other diagnostic techniques Arthroscopy of the Wrist Indications Complications Equipment Positioning and preparation of the patient General principles Fractures and Dislocations of the Carpal Bones, Including Kienböck Disease Fractures of the scaphoid Etiology Anatomy and blood supply of the scaphoid bone Diagnosis and treatment Nondisplaced, Stable Scaphoid Fractures Displaced, Unstable Scaphoid Fractures Nonunion of Scaphoid Fractures Styloidectomy Excision of the Proximal Fragment Excision of the Distal Scaphoid Proximal Row Carpectomy Malpositioned Nonunion of Scaphoid Fractures (“Humpback” Deformity) Vascularized Bone Grafts Arthrodesis of the Wrist Naviculocapitate fracture syndrome and capitate fractures Fractures of other carpal bones Fracture of the hamate Trapezium and trapezoid fractures Fractures of the lunate and kienböck disease Joint leveling procedures Capitate Shortening Osteotomies of the distal radius Core decompression Lunate revascularization procedures Prosthetic lunate replacement Distal Radioulnar and Ulnocarpal Joint Injuries Anatomy Diagnosis and treatment Lesions of the triangular fibrocartilage complex, including traumatic distal radioulnar joint instability Physical Examination Radiographic Evaluation Arthroscopic Evaluation Classification Treatment of Traumatic Lesions of the Triangular Fibrocartilage Complex (Palmer Class 1) Chronic instability of the distal radioulnar joint Procedures to stabilize the distal radioulnar joint Ulnar Impaction-Abutment and Distal Radioulnar Joint Arthritis Ulnar Shortening Procedures Procedures to stabilize the unstable proximal ulnar segment after distal ulnar excision Arthrodesis of the wrist Carpal Ligament Injuries and Instability Patterns Instability classification Progressive perilunar instability Rotary subluxation of the scaphoid Anterior dislocation of the lunate Palmar transscaphoid perilunar dislocations Dorsal transscaphoid perilunar dislocations Triquetrolunate and midcarpal instabilities Other instability patterns Treatment options for wrist ligament injuries and instability Capsulodesis Limited wrist arthrodesis Indications for Triscaphe Arthrodesis Contraindications for Triscaphe Arthrodesis Other limited wrist arthrodeses Triquetrohamate Arthrodesis Osteoarthritis of the Wrist References Supplemental References Chapter 70: Special Hand Disorders Aneurysm, Thrombosis, and Embolism in Radial, Ulnar, and Digital Arteries Thermal Burns Electrical Burns Radiation Burns Chemical Burns Frostbite Injection Injuries Shotgun Injuries Wringer Injuries Extravasation Injuries Focal Dystonia of the Hand Psychoflexed and Psychoextended Hands (Dysfunctional Postures) Factitious Hand Syndromes References Supplemental References Chapter 71: Paralytic Hand Principles of Tendon Transfer Planning Tendon Transfer Evaluating Muscles for Tendon Transfer Timing of Tendon Transfer Technical Considerations for Tendon Transfer Restoration of Pinch Restoration of Thumb Opposition Correction of Thumb Deformity Tendon Transfers to Restore Opposition Restoration of Adduction of the Thumb Restoration of Abduction of the Index Finger Restoration of Intrinsic Function of the Fingers Peripheral Nerve Palsies Radial Nerve Palsy Low Ulnar Nerve Palsy High Ulnar Nerve Palsy Low Median Nerve Palsy High Median Nerve Palsy Combined Low Median and Ulnar Nerve Palsy (At the Wrist) Combined High Median and Ulnar Nerve Palsy (Above the Elbow) Severe Paralysis From Damage to the Cervical Spinal Cord or Other Causes Tetraplegia Classification Principles of Management Elbow Extension Forearm Pronation Wrist Extension Key Pinch References Supplemental References Chapter 72: Cerebral Palsy of the Hand Patient Evaluation Nonoperative Management Operative Management Goals Principles Pronation Contracture of the Forearm Flexion Deformities of the Wrist and Fingers Thumb-in-Palm Deformity Treatment Swan-Neck Deformity References Supplemental References Chapter 73: Arthritic Hand Rheumatoid Arthritis Osteoarthritis Systemic Lupus Erythematosus Psoriatic Arthritis Reiter Syndrome Gout Scleroderma (Progressive Systemic Sclerosis) Nonoperative Treatment of Synovitis and Tenosynovitis Rheumatoid Nodules Staging of Operations Finger Deformities Caused by Rheumatoid Arthritis Intrinsic Plus Deformity Swan-Neck Deformity Intrinsic Release Boutonniere Deformity Interphalangeal Joint Arthroplasty Proximal Interphalangeal Joint Implant Arthroplasty Distal Interphalangeal Joint Deformities Ulnar Drift or Deviation of the Fingers Mild-to-Moderate Ulnar Drift Severe Ulnar Drift and Metacarpophalangeal Dislocation Extensor Tenosynovitis Extensor Tendon Rupture Flexor Tendon Rupture Persistent Proximal Interphalangeal Joint Synovitis Flexor Tenosynovitis Finger Joint Arthrodesis Distal Interphalangeal Joint Arthrodesis Deformities of the Thumb Classification Type I Type II Type III Type IV Osteoarthritis Correction of Arthritic Thumb Deformities Synovectomy Soft-Tissue Reconstruction Arthroplasty Trapeziometacarpal Ligament Reconstruction Trapeziometacarpal Arthroplasty Implant Arthroplasty Arthrodesis of Thumb Joints Trapeziometacarpal Arthrodesis Rheumatoid Deformities of the Wrist Synovitis of the Wrist Wrist Arthrodesis and Arthroplasty Distal Radioulnar Joint Arthroplasty Total Wrist Arthroplasty References Supplemental References Chapter 74: Compartment Syndromes and Volkmann Contracture Definition and History Anatomy Etiology Diagnosis Management Acute compartment syndrome of the forearm Established volkmann contracture of the forearm Muscle sliding operation of flexors for established volkmann contracture Established Intrinsic Muscle Contractures of the Hand Adducted thumb References Supplemental References Chapter 75: Dupuytren Contracture Pathogenesis Prognosis Nonoperative Treatment External Beam Radiation Collagenase Injections Manipulation Percutaneous Needle Aponeurotomy Operative Treatment References Supplemental References Chapter 76: Stenosing Tenosynovitis of the Wrist and Hand Stenosing Tenosynovitis De quervain disease Trigger finger and thumb Bowler’s thumb References Supplemental References Chapter 77: Compressive Neuropathies of the Hand, Forearm, and Elbow Carpal Tunnel Syndrome Diagnosis Treatment Surgical release Endoscopic release Unrelieved or recurrent carpal tunnel syndrome Ulnar Tunnel Syndrome Cubital Tunnel Syndrome and Tardy Ulnar Nerve Palsy Revision cubital tunnel surgery Pronator Syndrome and Anterior Interosseous Syndrome Examination Treatment Radial Tunnel Syndrome Examination Treatment References Supplemental References Chapter 78: Tumors and Tumorous Conditions of the Hand Classification Diagnosis Treatment Benign Tumors Lipoma Infiltrating Lipomas Lipoblastomas Intraneural Lipofibromas Giant Cell Tumor of the Tendon Sheath (Xanthoma) Benign Tumors of Fibrous Origin Recurring Digital Fibrous Tumor of Childhood or Infantile Digital Fibromatosis Juvenile Aponeurotic Fibroma or Calcifying Aponeurotic Fibroma Fibroma Desmoid Tumor Neurofibroma Glomus Tumor Hemangioma Lymphangioma Neurilemoma (Schwannoma) Osteoid Osteoma Enchondroma Benign Osteoblastoma Aneurysmal Bone Cyst Giant Cell Tumors of Bone Osteochondroma Synovial Chondromatosis Malignant Tumors Osteogenic Sarcoma Chondrosarcoma Epithelioid Sarcoma Squamous Cell Carcinoma Basal Cell Carcinoma Malignant Melanoma Fibrosarcoma Metastatic Tumors Rhabdomyosarcoma Ewing Sarcoma Tumorous Conditions Ganglion Epidermoid Cyst (Inclusion Cyst) Sebaceous Cyst Mucous Cyst Congenital Arteriovenous Fistula Pyogenic Granuloma Foreign Body Granuloma Gout Traumatic Neuroma Déjérine-Sottas Disease Calcinosis Calcinosis Circumscripta Turret Exostosis Carpometacarpal Boss Epidermolysis Bullosa Paget Disease References Supplemental References Chapter 79: Hand Infections Factors Influencing Hand Infections General Approach to Hand Infections Paronychia Chronic Paronychia Felon Subfascial Space Infections Web Space Infection (Collar Button Abscess) Deep Fascial Space Infections Subaponeurotic Space Infections Tenosynovitis Infections of Radial and Ulnar Bursae Septic Arthritis Finger Joint Infections Wrist Infections Osteomyelitis Human Bite Injuries Animal Bite Injuries Miscellaneous and Unusual Infections Herpetic Infections Infections in Drug Addicts Infections in Patients With Acquired Immunodeficiency Syndrome Necrotizing Fasciitis Gas Gangrene (Clostridial Myonecrosis) Mycobacterial Infections Tuberculosis Nontuberculous Mycobacterial Infections Fungal Infections Pyoderma Gangrenosum References Supplemental References Chapter 80: Congenital Anomalies of the Hand Principles of Management Incidence and Classification Embryology Malformations Upper Extremity Proximal-Distal Axis Transverse Deficiencies Prosthetic Management Surgical Treatment Intersegmental Deficiency Phocomelia Treatment Anteroposterior Axis Radial Longitudinal Deficiency Nonoperative Treatment Operative Treatment Ulnar Longitudinal Deficiency Nonoperative Treatment Operative Treatment Congenital Pseudarthrosis of the Ulna; Radioulnar Synostosis; Congenital Dislocation of the Radial Head Madelung Deformity Treatment Unspecified Shoulder (Sprengel Deformity, Congenital Muscular Torticollis, Pseudarthrosis of the Clavicle) Arthrogryposis Malformations of Hand Plate Proximal Distal Axis Brachydactyly (Hypoplastic Hands and Digits) Nonoperative Treatment Operative Treatment Anteroposterior Axis Radial (Thumb) Deficiency/Hypoplastic Thumb Type I Hypoplasia (Shortened Thumb) Type II Hypoplasia (Adducted Thumb) Type II and Type III Hypoplasia (Abducted Thumb) Type IV Hypoplasia (Pouce Flottant or Floating Thumb) Type V Hypoplasia (Absent Thumb) Pollicization for Reconstruction of the Thumb Complications Preaxial Polydactyly (Duplicate Thumb) Treatment Triphalangeal Thumb Treatment Ulnar Dimelia Treatment Postaxial Polydactyly Treatment Malformations Unspecified Soft Tissue Syndactyly Treatment Camptodactyly Treatment Thumb in Palm (Clasped Thumb) Nonoperative Treatment Operative Treatment Skeletal Clinodactyly (Delta Phalanx) Treatment Kirner Deformity Treatment Complex Synpolydactyly (Central Polydactyly) Treatment Cleft Hand Treatment Apert Syndrome Treatment Deformations Constriction Ring Syndrome (Amniotic Band Syndrome) Treatment Trigger Fingers Treatment Dysplasias Hypertrophy Macrodactyly Treatment References Supplemental References Part XIX: The Foot and Ankle Chapter 81: Surgical Techniques Preoperative Preparation Instruments Patient positioning Tourniquet Surgical Antiseptic Perioperative Medical Management Prophylactic antibiotics Prophylactic anticoagulation Perioperative Pain Management Regional anesthesia Forefoot block and ankle block Popliteal sciatic nerve block (prone) Lateral popliteal nerve block References Supplemental References Chapter 82: Disorders of the Hallux Hallux Valgus (Bunion) Preoperative assessment and management Postoperative considerations Soft-tissue procedures Combined soft-tissue and bony procedures Osteotomy of the distal first metatarsal Minimally invasive osteotomy Osteotomy of the proximal first metatarsal Proximal phalangeal osteotomy Triple osteotomy Arthrodesis of the first metatarsophalangeal joint Special circumstances Hallux valgus in the case of metatarsus adductus Hallux valgus in men Hallux valgus in athletes Hallux valgus in cerebral palsy Juvenile and adolescent hallux valgus (10 to 19 years old) Complications after surgery for hallux valgus Preventing complications Transfer metatarsalgia Recurrent deformity after simple bunionectomy Recurrent Hallux Valgus With Normal Distal Metatarsal Angle After Bunionectomy Recurrent Valgus Deformity with Abnormal Distal Metatarsal Articular Angle Recurrent Deformity After Basilar Metatarsal Osteotomy and First Web Space Dissection or Release Recurrent Deformity in Elderly Patients With Osteoarthritis Complications after chevron osteotomy Metatarsal Shortening Acquired hallux varus and intrinsic minus hallux Anatomy and pathogenesis Correction of Dynamic (Multiplanar) Hallux Varus Claw Toe (Intrinsic Imbalanced Hallux) Limitation of Metatarsophalangeal Joint Motion Hallux Extensus Neuroma and Hematoma Stress Fractures of the Lesser Metatarsal Complications of resection arthroplasty of the first metatarsophalangeal joint (keller procedure) Cock-Up Hallux Metatarsalgia Complications after arthrodesis of the first metatarsophalangeal joint Hallux Rigidus Nonoperative treatment Operative treatment Arthrodesis of the first metatarsophalangeal joint Resection arthroplasty (keller procedure) Proximal phalangeal extension osteotomies Conditions of the sesamoid Treatment Arthritis of the Interphalangeal Joint References Supplemental References Chapter 83: Disorders of Tendons and Fascia and Adolescent and Adult Pes Planus Disorders of the Posterior Tibial Tendon Classification Diagnosis Treatment Stage I disease (tenosynovitis) Stage II disease Subtalar Arthroereisis Stage III disease Medial Column Stabilization Stage IV disease Posterior tibial tendon insufficiency Insufficiency of posterior tibial tendon secondary to accessory navicular Kidner Procedure Pes planus and tarsal coalition Calcaneonavicular coalition Arthrodesis for Calcaneonavicular Coalition Talocalcaneal coalition Radiographic Findings Treatment Disorders of the Achilles Tendon Insertional achilles tendinopathy Diagnosis Treatment Noninsertional achilles tendinopathy Disorders of the Anterior Tibial Tendon Diagnosis Treatment Tenosynovitis Insertional tendinosis Complete rupture Disorders of the Peroneal Tendons Diagnosis Treatment Peroneal tendinitis Subluxation of the Peroneal Tendons Intrasheath peroneal tendon subluxation Tears and ruptures of the peroneal tendons Distal peroneal longus tendinitis associated with os peroneum: The painful os peroneum syndrome Injuries of the Flexor Tendons Flexor hallucis longus tendinitis and impingement Diagnosis Treatment Flexor hallucis longus tear Flexor digitorum longus tendon injury Painful Heel Etiology Clinical and radiographic findings Treatment References Supplemental References Chapter 84: Lesser Toe Abnormalities Metatarsophalangeal Joint Instability Etiology Anatomy and Biomechanics Diagnosis Treatment Axial Plane Deformity of the Metatarsophalangeal Joint Hammer Toe and Claw Toe Etiology Clinical Findings Treatment Soft-Tissue Procedures (Girdlestone; Taylor; Parrish; Mann and Coughlin) Bone and Joint Procedures Mild Deformity Moderate Deformity Severe Deformity Correction of Severe Deformity With Dislocation of the Metatarsophalangeal Joint Correction of a Dislocated Second Metatarsophalangeal Joint With Shortening Metatarsal Osteotomy Amputation For Severe Deformity Mallet Toe Etiology Treatment Combined Hammer Toe and Mallet Toe Deformity With Associated Double Corns Complications and Revision Surgery of Hammer Toe Deformities Corns (Helomata and Clavi) Etiology and Clinical Findings Treatment Hard Corn Soft Corn (Interdigital Corn) Plantar Corn (Intractable Plantar Keratosis) Excessive Metatarsal Length and Diffuse Plantar Keratosis and Metatarsalgia Bunionette (Tailor’s Bunion) Treatment Resection Osteotomy of the Metatarsal Freiberg Infraction Brachymetatarsia References Supplemental References Chapter 85: Arthritis of the Foot Inflammatory and Degenerative Arthritis Signs and symptoms Nonoperative Treatment Forefoot Etiology of joint destruction Treatment Avoiding complications in foot surgery Forefoot arthroplasty Arthrodesis of the first metatarsophalangeal joint in the rheumatoid patient Midfoot Treatment First metatarsal-medial cuneiform arthrodesis Midfoot arthrodesis Hindfoot Treatment Tibiotalocalcaneal and ankle arthrodeses References Supplemental References Chapter 86: Diabetic Foot Diabetic Foot Epidemiology Basic science History and physical examination Ulcer classification Laboratory evaluation Imaging Treatment Patient education Total contact casting Treatment of Peripheral Neuropathy Surgical management Trauma in diabetic patients Charcot Arthropathy Background Natural history Pathogenesis Classification Treatment References Supplemental References Chapter 87: Neurogenic Disorders Tarsal Tunnel Syndrome Anatomy and Etiology Clinical Findings and Diagnosis Treatment Anterior Tarsal Tunnel Syndrome (Deep Peroneal Nerve Entrapment) First Branch of Lateral Plantar Nerve Entrapment Medial Plantar Nerve Entrapment Sural Nerve Entrapment Superficial Peroneal Nerve Entrapment Interdigital Neuroma Pathologic Findings Signs and Symptoms Treatment Cavus Foot Etiology Physical Findings Radiographic Findings Treatment Flexible Forefoot-Driven (Plantar-Flexed First Ray) Cavovarus Deformity Proximal First Metatarsal Osteotomy and Plantar Fasciotomy Combined Mild Forefoot-Driven and Hindfoot-Driven Varus Deformity Osteotomy of the Calcaneus Stiff, Moderate Midfoot Cavovarus Deformity Stiff, Severe Cavovarus Deformity Associated With Arthrosis Claw Toes Summary of Cavus Foot Evaluation and Treatment References Supplemental References Chapter 88: Disorders of Nails Anatomy Trauma Dystrophic Nails (Onychogryposis, Onychomycosis) Other Lesions of the Nails Subungual exostosis Subungual and periungual fibromas Glomus tumor Malignant melanoma Ingrown Toenail (Onychocryptosis, Unguis Incarnatus) Etiology Nonoperative management Stage I (inflammatory stage) Stage II (abscess stage) Stage III (granulation stage) Operative management Long-Term Follow-Up References Supplemental References Chapter 89: Fractures and Dislocations of the Foot Fractures of the Calcaneus Intraarticular Fractures Mechanism Radiographic Evaluation Classification Treatment Decision-Making in Calcaneal Fractures Soft-Tissue Injury (Open Calcaneal Fractures) Complications and Prevention Wound Necrosis, Dehiscence, and Infection Loss of Reduction of Major Fragments Malreduction Sural Nerve and Peroneal Tendon Injuries Results Late Complications Calcaneal Fracture Malunion Subtalar Arthrodesis Extraarticular Fractures Fractures of the Calcaneal Tuberosity Fractures of the Sustentaculum Tali Fractures of the Anterior Process of the Calcaneus Fractures of the Talus Anatomy Talar Head Fractures Treatment Talar Neck Fractures Treatment Type I Fractures Types II, III, and IV Fractures Malunion of the Talar Neck Osteonecrosis of the Talar Body After Talar Neck Fracture Talar Body Fractures Fractures of the Lateral or Posterior Process of the Talus Lateral Process Fractures Posterior Process Fractures Talar Body Extrusion Subtalar Dislocations Midfoot Fractures and Dislocations Navicular/Cuboid/Cuneiform Fractures Fracture-Dislocations of the Tarsometatarsal Articulation (Lisfranc Joint) Classification Evaluation and Treatment Metatarsals Fracture of the Proximal Portion of the Fifth Metatarsal Inlay Bone Graft Distal Fifth Metatarsal Fracture Stress Fractures of the Metatarsals Complications Acute Fractures of the Metatarsals Phalangeal Dislocations Interphalangeal Joint of the Hallux First Metatarsophalangeal Joint Dislocation First Metatarsophalangeal Joint Sprain Phalangeal Fractures Sesamoid Fractures Treatment Osteochondritis of the Sesamoid Other Conditions of the Sesamoid References Supplemental References Chapter 90: Sports Injuries of the Ankle Acute Ligamentous Injuries Anatomy Diagnosis Inversion and Eversion Stress Tests Anteroposterior Stress Test (Anterior Drawer Sign) Stress View of the Ankle Mortise and Syndesmosis Magnetic Resonance Imaging Treatment Repair of Acute Rupture of the Deltoid Ligament Repair of Acute Rupture of the Ligaments of the Distal Tibiofibular Joint Repair of Acute Rupture of the Lateral Ligaments Chronic Instability After Injury Lateral Repair of Chronic Instability Medial Repair of Chronic Instability Peroneal Tendon Subluxation and Dislocation Internal Derangements Occult Lesions of the Talus and Calcaneus Sinus Tarsi Syndrome Osteochondral Ridges of the Talus and Tibia (Anterior and Posterior Impingement Syndromes) Osteochondral Lesions of the Talus (Osteochondral Fracture, Transchondral Fracture, Dome Fracture of the Talus) Arthroscopic Treatment References Supplemental References
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