Handbook of Fractures

896 Pages·2014·13.86 MB·English

by  Kenneth Egol

SECTION EDITORS
PEDIATRIC FRACTURES AND DISLOCATIONS
Norman Otsuka, MD
Joseph E. Milgram Professor of Orthopaedic Surgery
Associate Chief of the Division of the Pediatric Orthopaedic Surgery
Director of the Neuromuscular and Cerebral Palsy Center
Director of the Center for Children
Departments of Orthopaedic Surgery and Pediatrics
Hospital for Joint Diseases
NYU Langone Medical Center
New York, New York
AXIAL SKELETON FRACTURES
Themi Protopsaltis, MD
Assistant Professor
Department of Orthopaedic Surgery
Hospital for Joint Diseases
NYU Langone Medical Center
New York, New York

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Fifth edition
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Library of Congress Cataloging-in-Publication Data
Egol, Kenneth A., 1967- , author.
Handbook of fractures / Kenneth A. Egol, Kenneth J. Koval, Joseph D. Zuckerman. — Fifth edition.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4511-9362-6 (alk. paper)
I. Koval, Kenneth J., author. II. Zuckerman, Joseph D. (Joseph David), 1952- , author. III. Title.
[DNLM: 1. Fractures, Bone—Handbooks. 2. Dislocations—Handbooks. WE 39]
RD101
617.1'5—dc23
2014032433
This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to
accuracy, comprehensiveness, or currency of the content of this work.
This work is no substitute for individual patient assessment based on healthcare professionals’ examination of each patient and
consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data,
and other factors unique to the patient. The publisher does not provide medical advice or guidance, and this work is merely a
reference tool. Healthcare professionals, and not the publisher, are solely responsible for the use of this work including all medical
judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information, independent professional verification of medical
diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made, and healthcare
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of use, warnings, and side effects and identify any changes in dosage schedule or contradictions, particularly if the medication to
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LWW.com
To my family, Lori, Alexander, Jonathan, and Gabrielle, and to my mentors KJK, JDZ, and MJB.
– Kenneth A. Egol
To my wife and children who bring me joy in life. And to my father who was my inspiration and role model in
orthopaedics.
– Kenneth J. Koval
To the residents and faculty of the NYU Hospital for Joint Diseases Department of Orthopaedic Surgery for all of
their support during the past 30 years.
– Joseph D. Zuckerman
CONTENTS
Preface
I. GENERAL CONSIDERATIONS
1 Closed Reduction, Casting, and Traction
2 Multiple Trauma
3 Open Fractures
4 Gunshot Wounds
5 Pathologic Fractures
6 Periprosthetic Fractures
7 Orthopaedic Analgesia
II. AXIAL SKELETON FRACTURES
8 General Spine
9 Cervical Spine
10 Thoracolumbar Spine
III. UPPER EXTREMITY FRACTURES AND DISLOCATIONS
11 Clavicle Fractures
12 Acromioclavicular and Sternoclavicular Joint Injuries
13 Scapula Fractures
14 Glenohumeral Dislocation
15 Proximal Humerus Fractures
16 Humeral Shaft Fractures
17 Distal Humerus
18 Elbow Dislocation
19 Olecranon
20 Radial Head
21 Radius and Ulna Shaft
22 Distal Radius
23 Wrist
24 Hand
IV. LOWER EXTREMITY FRACTURES AND DISLOCATIONS
25 Pelvis
26 Acetabulum
27 Hip Dislocations
28 Femoral Head
29 Femoral Neck Fractures
30 Intertrochanteric Fractures
31 Subtrochanteric Fractures
32 Femoral Shaft
33 Distal Femur
34 Knee Dislocation (Femorotibial)
35 Patella and Extensor Mechanism Injuries
36 Tibial Plateau
37 Tibia/Fibula Shaft
38 Injuries about the Ankle
39 Calcaneus Fractures
40 Talus
41 Fractures of the Midfoot and Forefoot
V. PEDIATRIC FRACTURES AND DISLOCATIONS
42 Pediatric Orthopaedic Surgery: General Principles
43 Pediatric Shoulder
44 Pediatric Elbow
45 Pediatric Forearm
46 Pediatric Wrist and Hand
47 Pediatric Hip
48 Pediatric Femoral Shaft
49 Pediatric Knee
50 Pediatric Tibia and Fibula
51 Pediatric Ankle
52 Pediatric Foot
VI. INTRAOPERATIVE IMAGING
53 Intraoperative Patient Positioning and Fluoroscopy for Fracture Surgery: A Suggested Guide to Obtaining the Quality
Images
William Rossy
Index
PREFACE
This book represents the work of many physicians who trained at the Hospital for Joint Diseases. Starting in the 1980s, the
Department of Orthopaedic Surgery initiated a weekly, didactic topic-related fracture case conference. This conference
consisted of a short lecture presented by a senior resident on pertinent anatomy, fracture mechanism, radiographic and
clinical evaluation, and classification and treatment options, followed by a series of cases that were used to further clarify the
options for fracture care. The senior resident was also responsible for preparing a handout on the fracture topic, which was
distributed prior to the lecture.
Over time, it became apparent that these topic-related fracture handouts were very useful as a reference for later study
and were utilized by incoming residents as an aid in the Emergency Department. This resulted in the original compilation of
the “Hospital for Joint Diseases Fracture Manu”a lw, hich was organized and prepared for publicatio“inn -house,” by
ourselves, two senior residents Scott Alpert and Ari Ben-Yishay, and our editorial associate, William Gree“nF.r aTchtue re
Manual” became very popular, very quickly. Its popularity led to the preparation and publication of the second edition. The
third edition was designed, in part, to accompany Rockwood and Gr’ese ntextbook Fractures in Adults, as was the fourth
edition, which was also completely updated.
We are very proud to present the fifth edition of t“hFer acture Manual.” What began as handouts for our fracture
conferences has evolved into one of the most widely utilized textbooks in orthopaedic surgery. We have once again tried to
keep it “pocket-size” despite the ever-increasing expanse of material. Most importantly, we have tried to kee“pF trhaec ture
Manual” true to its roots as a comprehensive, useful guide for the management of patients with fractures and associated
injuries. We hope that the users of th“iFs racture Manua”l find it helpful in their daily practice of fracture care.
Kenneth A. Egol, MD
Kenneth J. Koval, MD
Joseph D. Zuckerman, MD
General
Considerations