Classification and Diagnosis in Orthopaedic Trauma

270 Pages·2008·9.89 MB·English

by  Rahij Anwar

ClassificationandDiagnosisinOrthopaedicTrauma

Classification and
Diagnosis in
Orthopaedic Trauma
RAHIJ ANWAR
M.S.(Orth.);M.Sc.(Trauma);M.R.C.S.(Ed.)
SpecialistRegistrar(Trauma&Orthopaedics)
SouthEastThamesRegion(LondonDeanery)
Maidstone&TunbridgeWellsNHSTrust
UK
KENNETH W. R. TUSON
M.B.,Ch.B,F.R.C.S.Orth,Edinburgh,F.R.C.S.Eng.
ConsultantOrthopaedicSurgeon
MaidstoneandTunbridgeWellsNHSTrust
FormerlyDirectorofA&EMedicineandSurgery,Kent&SussexHospital
ImmediatepastPresidentofWorldOrthopaedicConcern
RegionalAdvisor,OrthopaedicSurgery,SouthEastThames
UK
SHAH ALAM KHAN
M.S.(Orth),DipNationalBoards(Ortho.),M.R.C.S.(Ed.),M.Ch.Ortho.
(Liverpool),FRCS(Glasgow)
AssistantProfessor,DepartmentofOrthopaedicSurgery
AllIndiaInstituteofMedicalSciences
AnsariNagar,NewDelhi-110029
India
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First published in print format 2008
ISBN-13 978-0-511-38856-9 eBook (NetLibrary)
ISBN-13 978-0-521-70028-3 paperback
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Thisbookisdedicatedto
Huma
(forhersupportandunfailingencouragement)
and
theLateMrsS.Pant
(BiologyteacheratOurLadyFatimaSchool,Aligarh,India
wholaidthefoundationsofourfutureasdoctors)

Contents
Foreword pagexi
Preface xiii
Acknowledgements xv
Part I: General principles
1.1 Terminologyinorthopaedictrauma 3
1.2 Fractures:generalaspects 5
1.3 Advancedtraumalifesupportandmultipletrauma 15
1.4 Fracturehealing 21
1.5 Openfractures 23
1.6 Periprostheticfractures 26
1.7 Peripheralnerveinjuries 28
Part II: Upper limb
2.1 Shoulderandarm 37
2.1.A Fracturesoftheclavicle 37
2.1.B Fracturesoftheproximalhumerus 40
2.1.C Shoulderdislocations 46
2.1.D Injuriestotheacromioclavicularjoint 50
2.1.E Injuriestothesternoclavicularjoint 52
2.1.F Fracturesofthescapula 54
2.1.G Fracturesoftheshaftofthehumerus 56
2.2 Elbowandforearm 62
2.2.A Supracondylarfractures 62
2.2.B Intercondylar(TorY)fracturesofthehumerus 67
2.2.C Fracturesofthelateralcondyle 70
2.2.D Fracturesofthemedialcondyle 72
2.2.E Fracturesofthecapitellum(Kocherfracture) 72
2.2.F Fracturesofthemedialepicondyle 74
2.2.G Dislocationsoftheelbow 76
2.2.H Fracturesofthecoronoidprocess 79
2.2.I Fracturesoftheolecranon 81
2.2.J Fracturesoftheradialhead 85
2.2.K Diaphysealfracturesoftheradiusandulna 88
vii
C 2.2.L Monteggiafractures 92
o
n 2.2.M Galeazzifractures 95
te
n 2.3 Wristandhand 98
ts
2.3.A Fracturesofthedistalradius 98
2.3.B Fracturesofthescaphoid 107
2.3.C Fracturesofothercarpalbones(lunate,capitate,etc.) 111
2.3.D Carpalinstability 112
2.3.E Fracturesofthefirstmetacarpal 114
2.3.F Fracturesofothermetacarpals(secondtofifth) 116
2.3.G Ulnarcollateralligamentinjuryofthethumb(gamekeeper’s
orskier’sthumb) 118
2.3.H Phalangealfractures 119
2.3.I Dislocationsoftheinterphalangealjoints(PIP/DIP) 121
Part III: Lower limb
3.1 Pelvis 127
3.1.A Fracturesofthepelvis 127
3.1.B Fracturesoftheacetabulum 130
3.2 Hipandthigh 134
3.2.A Dislocationsofthehip 134
3.2.B Fracturesofthefemoralhead 136
3.2.C Fracturesoftheneckoffemur:generalaspects 138
3.2.D Femoralneckfractures(subcapital) 140
3.2.E Intertrochantericfractures 147
3.2.F Subtrochantericfractures 150
3.2.G Femoralshaftfractures 154
3.3 Kneeandleg 160
3.3.A Supracondylarfracturesofthefemur 160
3.3.B Condylarandintercondylarfracturesofthefemur 163
3.3.C Fracturesofthetibialplateau 164
3.3.D Fracturesofthetibialspine(intercondylareminence) 168
3.3.E Fracturesofthepatella 170
3.3.F Fracturesoftheproximalfibula 172
3.3.G Dislocationsoftheknee 173
3.3.H Anteriorcruciateligamentinjuries 175
3.3.I Posteriorcruciateligamentinjuries 178
3.3.J Medialcollateralligamentinjuries 179
3.3.K Lateralcollateralligamentinjuries 181
3.3.L Meniscalinjuries 181
3.3.M Posterolateralcornerinjuriesoftheknee 183
3.3.N Osteochondralfracturesoftheknee 185
3.3.O Extensormechanisminjuries 185
3.3.P Tibialshaftfractures 187
3.3.Q Fracturesofthefibularshaft 192
3.3.R Stressfracturesofthetibiaorfibula 193
3.4 Ankleandfoot 194
3.4.A Anklefractures 194
3.4.B Pilon(tibialplafond)fractures 200
viii 3.4.C Fracturesoftheneckoftalus 205
3.4.D Fracturesofthebody,headandprocessofthetalus 207 C
o
3.4.E Dislocationofthetalus 207 n
3.4.F Fracturesofthecalcaneum 207 te
n
3.4.G Fracturesofthemidtarsalbones(navicularcuboid, ts
cuneiforms) 212
3.4.H Tarsometatarsaljointinjuries 213
3.4.I Fracturesofthefifthmetatarsal 216
3.4.J Fracturesofothermetatarsals(I–IV) 218
3.4.K Dislocationsofthemetatarsophalangealjoints 219
3.4.L Phalangealfractures 220
3.4.M Dislocationsoftheinterphalangealjoints 221
3.4.N RuptureoftheAchillestendon 221
Part IV: Spinal injuries
4.1 Spinalinjuries 225
4.1.A Spinalinjuries:generalaspects 225
4.1.B Incompletespinalinjuries 229
4.1.C Fracturesofthecervicalspinewitheponyms 230
4.1.D Atlanto-occipitalinjuries 231
4.1.E Fracturesoftheatlas 233
4.1.F Atlantoaxialrotatorysubluxation 233
4.1.G Fracturesofthedens(odontoid) 234
4.1.H Traumaticspondylolisthesisoftheaxis(Hangman’sfracture) 236
4.1.I Injuriesofthesubaxialcervicalspine 237
4.1.J Injuriesofthethoracolumbarspine:generalaspects 237
Index 241
ix