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Handbook of Fractures
Hyperextension or Rotation of the Ipsilateral Arm May Result in
Table of Contents
Free Topics
16. Humeral Shaft Fractures
17. Distal Humerus
20. Radial Head
24. Fractures and Dislocations of the Hand
3. Open Fractures
9. Cervical Spine
Anterior Glenohumeral Dislocation
Blood Replacement
Complications of Casts and Splints
Dedication
Differential Diagnosis of Hypotension in Trauma
F - 10-2. A Screening Examination of the Lower Extremities Assesses the Motor
F - 10-6. Denis Three-Column Model of Spinal Stability, Which Involves Anterior (Anterior
F - 11-1. Radiograph of a Displaced Middle Third Clavicle Fracture
F - 1-2. Position of Function for the MCP Joint
F - 13-1. Anatomic Classification
F - 13-5. Sssc
F - 1-4. Technique of Inserting Skeletal Pins for Femoral Traction
F - 14-1. (A)Cross-Sectional Anatomy of a Normal Shoulder
F - 14-13. Locked Inferior Dislocation of the Glenohumeral Joint, Also Known As
F - 14-3. Hill-Sachs Lesion Associated with Anterior Shoulder Dislocation
F - 15-3. Axillary Radiograph Demonstrating a Posterior Fracture-Dislocation of the Shoulder
F - 16-3. Plate and Screw Fixation of a Distal Third Humeral Shaft Fracture
F - 18-6. Lateral Radiograph of the Elbow Demonstrating a Transolecranon Fracture-Dislocation
F - 18-8. Example of a Fracture-Dislocation of the Elbow Treated with a
F - 21-2. The Bado Classification of Monteggia Fractures
F - 22-2. The Normal Radiographic Measurements of the Distal Radius
F - 23-9. Mayfield Stages of Progressive Perilunate Instability
F - 24-6. Fracture Patterns Seen in the Distal Phalanx Include Longitudinal Shaft
F - 25-2. Pelvic Binder
F - 25-6. Young and Burgess Classification of Pelvic Ring Fractures
F - 26-3. Iliac Oblique View of the Acetabulum
F - 26-5. Letournel Classification of Acetabular Fractures
F - 3-1. Example of a VAC Dressing Used for an Open Medial Ankle Wound
F - 6-5. Classification of Periprosthetic Tibial Fractures
F - 6-7. Nonoperative Treatment of a Humeral Periprosthetic Fracture
F - 7-1. Surgical Anatomy for the Digital Block Technique
F - 7-5. IV Regional Blockade (Bier Block)
F - 9-13. The Five Stages of Compression Extension Injuries
F - 9-5. The Powers Ratio is Determined by Drawing a Line from
Figure - Position of Function for the MCP Joint
Figure - Technique of Inserting Skeletal Pins for Femoral Traction
Flowchart - NYU Langone Orthopedic Trauma Service Algorithm for Evaluation - Flowchart
Flowchart - Treatment Algorithm for Acetabular Fractures - Flowchart
Fractures of the Radial Shaft
Introduction
Pharmacology: Classes of Drugs
Preface
Radiographic Evaluation
Regional Blocks and Conscious Sedation
Section Editors
T - 10-1. Thoracic and Thoracolumbar Spine Stability Scale
T - 2-2. Revised Trauma Score: Trauma Scoring Systems
T - 3-2. Gustilo and Anderson's Classification of Open Fractures
T - 5-3. Mirels Criteria for Risk of Fracture
T - 8-2. Spinal Cord and Conus Medullaris Reflexes
Table - Gustilo and Anderson's Classification of Open Fractures
Table - Revised Trauma Score: Trauma Scoring Systems
The Team
Traction
1. General Considerations
1. Closed Reduction, Casting, and Traction
Casting
Common Splinting Techniques
Complications of Casts and Splints
F - 1-1. A Sugar-Tong Plaster Splint is Wrapped around the Elbow and
F - 1-2. Position of Function for the MCP Joint
F - 1-3. Skeletal Traction Sites
F - 1-4. Technique of Inserting Skeletal Pins for Femoral Traction
Positions of Function
Principles of Closed Reduction
Traction
2. Multiple Trauma
Airway Control
Blood Replacement
Breathing
Circulation
Classification of Hemorrhage
Concomitant Injuries
Decision to Operate
Differential Diagnosis of Hypotension in Trauma
Disability (Neurologic Assessment)
Exposure
F - 2-1. Mortality Rate Increases with Increasing Age
F - 2-2. Factors Associated with the "Second Hit" Phenomenon
Field Triage
Golden Hour
Indications for Immediate Surgery
Initial Management of the Patient in Shock
Injury Severity Score (Table 2.3)
Introduction
Pneumatic Antishock Garment or Military Antishock Trousers (Used in Field Only)
Radiographic Evaluation
Resuscitation
Stabilization
T - 2-1. Glasgow Coma Scale
T - 2-2. Revised Trauma Score: Trauma Scoring Systems
T - 2-3. Evaluation of Multiple Trauma Patient Injury Severity Score
The Team
Trauma Deaths
3. Open Fractures
3. Open Fractures
F - 3-1. Example of a VAC Dressing Used for an Open Medial Ankle Wound
T - 3-1. Energy Transmitted by Injury Mechanism
T - 3-2. Gustilo and Anderson's Classification of Open Fractures
T - 3-3. Factors that Modify Open Fracture Classification Regardless of Initial Skin
T - 3-4. Requirements for Tetanus Prophylaxis
T - 3-5. Factors of Muscle Viability
4. Gunshot Wounds
4. Gunshot Wounds
F - 4-1. Pictorial Description of the Formation of the Temporary and Permanent
F - 4-2. Example of Clothing Contamination of a Bullet Wound at the
5. Pathologic Fractures
5. Pathologic Fractures
T - 5-1. Disorders Producing Osteopenia
T - 5-2. Search for Primary Source in Patient with Suspected Metastatic Bone
T - 5-3. Mirels Criteria for Risk of Fracture
6. Periprosthetic Fractures
F - 6-1. Example of a Postoperative Distal Femoral Periprosthetic Femur Fracture
F - 6-2. Aaos Classification of Fractures Associated with Hip Arthroplasty
F - 6-3. Vancouver Classification Scheme for Periprosthetic Fractures About Total Hip Arthroplasties
F - 6-4. Lewis and Rorabeck Classification Scheme for Periprosthetic Fractures of the
F - 6-5. Classification of Periprosthetic Tibial Fractures
F - 6-6. Classification of Periprosthetic Shoulder Fractures
F - 6-7. Nonoperative Treatment of a Humeral Periprosthetic Fracture
F - 6-8. The Mayo Classification of Periprosthetic Fractures About a Total Elbow
Total Elbow Arthroplasty
Total Hip Arthroplasty
Total Knee Arthroplasty
Total Shoulder Arthroplasty
7. Orthopaedic Analgesia
F - 7-1. Surgical Anatomy for the Digital Block Technique
F - 7-2. Surgical Anatomy for the Wrist Block Technique
F - 7-3. Surgical Anatomy for the Axillary Block Technique
F - 7-4. Surgical Anatomy for the Ankle Block Technique
F - 7-5. IV Regional Blockade (Bier Block)
Introduction
Local Anesthetics
Moderate Sedation
Nitrous Oxide
Opioids
Pharmacology: Classes of Drugs
Regional Blocks and Conscious Sedation
Sedatives
Vasoconstrictors
2. Axial Skeleton Fractures
10. Thoracolumbar Spine
10. Thoracolumbar Spine
F - 10-1. The Relationship Between Myelomeres (Spinal Cord Segments) and the Vertebral Bodies
F - 10-2. A Screening Examination of the Lower Extremities Assesses the Motor
F - 10-3. A Pain and Temperature Dermatome Chart
F - 10-4. Sacral Sparing May Include the Triad of Perianal Sensation, Rectal
F - 10-5. The Bulbocavernosus Reflex Arc is Mediated by the Conus Medullaris
F - 10-6. Denis Three-Column Model of Spinal Stability, Which Involves Anterior (Anterior
F - 10-7. Revised AOSpine Thoracolumbar Classification
T - 10-1. Thoracic and Thoracolumbar Spine Stability Scale
T - 10-2. Lumbar Spine Stability Scale
T - 10-3. Basic Types of Spinal Fractures and Columns Involved in Each
8. General Spine
8. General Spine
F - 8-1. The ASIA Scoring Sheet Enables Accurate Classification of Neurologic Impairment
T - 8-1. Neurogenic and Hypovolemic Shock
T - 8-2. Spinal Cord and Conus Medullaris Reflexes
9. Cervical Spine
9. Cervical Spine
F - 9-1. The Components of the Cervical Three-Column Spine
F - 9-10. The Five Stages of Compression Flexion Injuries
F - 9-11. The Three Stages of Vertical Compression Injuries
F - 9-12. The Four Stages of Distraction Flexion Injuries
F - 9-13. The Five Stages of Compression Extension Injuries
F - 9-14. The Two Stages of Distraction Extension Injuries
F - 9-15. In Lateral Flexion Injuries, Blunt Trauma from the Side Places
F - 9-16. Closed Reduction Technique
F - 9-2. (A)Prevertebral Soft Tissue Shadow
F - 9-3. Radiographic Indications of Instability
F - 9-4. Anderson and Montesano Classification of Occipital Condyle Fractures
F - 9-5. The Powers Ratio is Determined by Drawing a Line from
F - 9-6. Classification of Atlas Fractures (According to Levine)
F - 9-7. An Avulsion (Arrow) of the Transverse Ligament from the Ring
F - 9-8. The Odontoid Fracture Classification of Anderson and D'alonzo
F - 9-9. Classification of Traumatic Spondylolisthesis of the Axis (Hangman's Fracture) (According
3. Upper Extremity Fractures and Dislocations
11. Clavicle Fractures
11. Clavicle Fractures
F - 11-1. Radiograph of a Displaced Middle Third Clavicle Fracture
F - 11-2. Classification of Group II Clavicle Fractures
12. Acromioclavicular and Sternoclavicular Joint Injuries
Acromioclavicular Joint Injury
F - 12-1. Normal Anatomy of the AC Joint
F - 12-2. An Indirect Force Applied Up through the Upper Extremity (E.g.,
F - 12-3. Classification of Ligamentous Injuries to the AC Joint
F - 12-4. Cross Sections through the Thorax at the Level of the SC Joint
F - 12-5. Mechanisms that Produce Anterior or Posterior Dislocations of the SC
F - 12-6. Hobbs View: Positioning of the Patient for x-Ray Evaluation of
F - 12-7. Serendipity View: Positioning of the Patient to Take the "Serendipity"
F - 12-8. Technique for Closed Reduction of the SC Joint
Sternoclavicular Joint Injury
T - 12-1. Classification of Acromioclavicular Joint Injury
13. Scapula and Thorax Fractures
F - 13-1. Anatomic Classification
F - 13-2. Ideberg Classification of Glenoid Fractures into Five Types, with the
F - 13-3. Type I Acromion Fractures are Nondisplaced and Include Type IA
F - 13-4. Classification of Coracoid Fractures
F - 13-5. Sssc
F - 13-6. The Glenopolar Angle Subtended by a Line Parallel to the
F - 13-7. Diagram of Scapulothoracic Dissociation, Demonstrating Lateral Displacement of the Scapula
F - 13-8. Three-Dimensional CT Scan Demonstrating Multiple Rib Fractures in a Patient
Rib Fractures
Scapula Fractures
14. Glenohumeral Dislocation
14. Glenohumeral Dislocation
Anterior Glenohumeral Dislocation
F - 14-1. (A)Cross-Sectional Anatomy of a Normal Shoulder
F - 14-10. (A)The Position of the Patient for the Stryker Notch View
F - 14-11. Closed Reduction of the Left Shoulder with Traction Against Countertraction
F - 14-12. The Stimson Technique for Closed Shoulder Reduction
F - 14-13. Locked Inferior Dislocation of the Glenohumeral Joint, Also Known As
F - 14-2. Anterior Glenohumeral Ligaments
F - 14-3. Hill-Sachs Lesion Associated with Anterior Shoulder Dislocation
F - 14-4. Technique for Testing Axillary Nerve Function
F - 14-5. Evaluation of the Injured Shoulder in Varying Degrees of Abduction
F - 14-6. Technique for Obtaining AP (A) and True AP (B) Radiographs
F - 14-7. (A)The Axillary Lateral x-Ray View
F - 14-8. Positioning of the Patient for the Velpeau Axillary Lateral View x-Ray
F - 14-9. West Point View for the Identification of a Glenoid Rim Lesion
Inferior Glenohumeral Dislocation (Luxatio Erecta)
Posterior Glenohumeral Dislocation
Superior Glenohumeral Dislocation
15. Proximal Humerus Fractures
15. Proximal Humerus Fractures
F - 15-1. Displacement of the Fracture Fragments Depends on the Pull of
F - 15-2. The Neer Classification of Proximal Humerus Fractures
F - 15-3. Axillary Radiograph Demonstrating a Posterior Fracture-Dislocation of the Shoulder
F - 15-4. Right Shoulder Deltopectoral Approach Demonstrating Access to the Proximal Humerus
F - 15-5. Three-Dimensional Computed Tomography Scan Depicting Heterotopic Ossification Following Fracture-Dislocation of
16. Humeral Shaft Fractures
16. Humeral Shaft Fractures
F - 16-1. The Neurovascular Anatomy of the Upper Arm
F - 16-2. Functional Brace Used for a Humeral Shaft Fracture
F - 16-3. Plate and Screw Fixation of a Distal Third Humeral Shaft Fracture
F - 16-4. Intramedullary Nail Fixation of a Humeral Shaft Fracture
F - 16-5. External Fixation of a Humeral Shaft Fracture Sustained Secondary to
T - 16-1. Position of Fracture Fragments
17. Distal Humerus
17. Distal Humerus
F - 17-1. The Distal-Most Part of the Lateral Column is the Capitellum,
F - 17-2. (A)The Joint Surface to Shaft Axis is 4 to 8
F - 17-3. Example of Exposure with an Olecranon Osteotomy Following Fracture Fixation
F - 17-4. Classification of Condylar Fractures According to Milch and the Location
F - 17-5. (A)Type I (Hahn-Steinthal) Capitellar Fracture
18. Elbow Dislocation
18. Elbow Dislocation
F - 18-1. The Elbow is an Inherently Stable Joint
F - 18-2. The Capsuloligamentous Structures of the Elbow are Injured in a
F - 18-3. Elbow Dislocation Classified Based on the Direction of Displacement of
F - 18-4. Regan and Morrey Classification of Coronoid Fractures
F - 18-5. Posterolateral Rotatory Instability Occurs in Several Stages
F - 18-6. Lateral Radiograph of the Elbow Demonstrating a Transolecranon Fracture-Dislocation
F - 18-7. (A)Parvin Method of Closed Reduction of an Elbow Dislocation
F - 18-8. Example of a Fracture-Dislocation of the Elbow Treated with a
19. Olecranon
19. Olecranon
F - 19-1. The Mayo Classification of Olecranon Fractures Divides Fractures According to
F - 19-2. Schatzker Classification of Olecranon Fractures
F - 19-3. Example of a Figure-of-Eight Tension Band Construct
20. Radial Head
20. Radial Head
F - 20-1. Schematic (A) and Radiograph (B) Demonstrating the Radial Head-Capitellum View
F - 20-2. Modified Mason Classification of Radial Head and Neck Fractures
F - 20-3. The Nonarticular Area of the Radial Heador the So-Called Safe
F - 20-4. Examples of Distal Radioulnar Joint Fixation in an Essex-Lopresti Injury
21. Radius and Ulna Shaft Fractures
21. Radius and Ulna Shaft Fractures
F - 21-1. Diagram Showing the Soft Tissue Connections of the Radius and
F - 21-2. The Bado Classification of Monteggia Fractures
Fractures of Both the Radius and Ulna Shafts
Fractures of the Radial Shaft
Fractures of the Ulna Shaft
22. Distal Radius Fractures
22. Distal Radius Fractures
F - 22-1. Anteroposterior (A), Lateral (B), and Oblique (C) Plain Radiographs of
F - 22-2. The Normal Radiographic Measurements of the Distal Radius
F - 22-3. Frykman Classification of Distal Radius Fractures
F - 22-4. Eponymic Classification of Five Basic Types of Distal Radius Fractures:
23. Wrist Fractures
23. Wrist Fractures
F - 23-1. The Wrist is Composed of Two Rows of Bones that
F - 23-2. The Palmar Capsule Consists of Two Major Ligamentous Inclusions: The
F - 23-3. The Intra-Articular Intrinsic Ligaments Connect Adjacent Carpal Bones
F - 23-4. Schematic Drawing of the Arterial Supply of the Palmar Aspect
F - 23-5. Schematic Drawing of Carpal Instability
F - 23-6. Types of Scaphoid Fractures
F - 23-7. The Vascular Supply of the Scaphoid is Provided by Two
F - 23-8. Vulnerable Zones of the Carpus
F - 23-9. Mayfield Stages of Progressive Perilunate Instability
Lunotriquetral Dissociation
Perilunate Dislocations and Fracture-Dislocations
Scapholunate Dissociation
Specific Fractures
Ulnocarpal Dissociation
24. Fractures and Dislocations of the Hand
24. Fractures and Dislocations of the Hand
F - 24-1. Effects of Flexion and Extension on the Collateral and Accessory
F - 24-2. Reduction of Metacarpal Fractures Can Be Accomplished by Using the
F - 24-3. The Most Recognized Patterns of Thumb Metacarpal Base Intra-Articular Fractures
F - 24-4. Displacement of Bennett Fractures is Driven Primarily by the Abductor
F - 24-5. (A)Lateral View, Showing the Prolonged Insertion of the Superficialis Tendon
F - 24-6. Fracture Patterns Seen in the Distal Phalanx Include Longitudinal Shaft
F - 24-7. An Intimate Relationship Exists Between the Three Layers of the
F - 24-8. Simple MCP Joint Dislocations are Spontaneously Reducible and Usually Present
F - 24-9. In the Stener Lesion, the Adductor Aponeurosis Proximal Edge Functions
4. Lower Extremity Fractures and Dislocations
25. Pelvis Fractures
25. Pelvis Fractures
F - 25-1. Right Innominate Bone of an Adult with Osteologic Features Indicated
F - 25-2. Pelvic Binder
F - 25-3. AP View
F - 25-4. Inlet View
F - 25-5. Outlet View
F - 25-6. Young and Burgess Classification of Pelvic Ring Fractures
F - 25-7. NYU Langone Orthopedic Trauma Service Algorithm for Evaluation
T - 25-1. Pelvic Injury Classification Keys According to the Young and Burgess
26. Acetabulum Fractures
26. Acetabulum Fractures
F - 26-1. (A)A Diagram of the Two Columns As an Inverted Y
F - 26-2. (A,B)Major Landmarks of the Acetabulum: Iliopectineal Line (Anterior Column), Ilioischial
F - 26-3. Iliac Oblique View of the Acetabulum
F - 26-4. Obturator Oblique View of the Acetabulum
F - 26-5. Letournel Classification of Acetabular Fractures
F - 26-6. Treatment Algorithm for Acetabular Fractures
F - 26-7. Morel-Lavalle Lesion (Skin Degloving Injury)
T - 26-1. Judet-Letournel Classification of Acetabulum Fractures
27. Hip Dislocations
27. Hip Dislocations
F - 27-1. (A)Sciatic Nerve Impingement by the Posteriorly Dislocated Femoral Head.(B)Sciatic Nerve
F - 27-2. The Hip Capsule and its Thickenings (Ligaments) As Visualized Anteriorly
F - 27-3. Vascular Anatomy of the Femoral Head and Neck
F - 27-4. Thompson and Epstein Classification of Posterior Hip Dislocations
F - 27-5. Epstein Classification of Anterior Hip Dislocations
F - 27-6. The Allis Reduction Technique for Posterior Hip Dislocations
F - 27-7. The Stimson Gravity Method of Reduction
28. Femoral Head Fractures
28. Femoral Head Fractures
F - 28-1. The Pipkin Classification of Dislocations with Femoral Head Fractures
F - 28-2. A Coronal CT Cut Demonstrating a Displaced Femoral Head Fracture
F - 28-3. Following Repair of Fracture in Figure 28.2 Via an Anterior Approach
T - 28-1. Approaches to Femoral Head Fractures
29. Femoral Neck Fractures
29. Femoral Neck Fractures
F - 29-1. A Cross-Table Lateral View of the Affected Hip is Obtained
F - 29-2. An MRI Scan Depicting a Nondisplaced Femoral Neck Fracture
F - 29-3. The Pauwel Classification of Femoral Neck Fractures is Based on
F - 29-4. The Garden Classification of Femoral Neck Fractures
F - 29-5. Algorithm for Treatment of Intracapsular Femoral Neck Fractures
30. Intertrochanteric Fractures
30. Intertrochanteric Fractures
F - 30-1. Classification of Trochanteric Hip Fractures
F - 30-2. Basicervical Neck Fractures are Located Just Proximal to or Along
F - 30-3. Reverse Oblique Intertrochanteric Hip Fracture
F - 30-4. A Trochanteric Fracture that Has Been Perfectly Reduced and Fixed
F - 30-5. The Tip-Apex Distance, Expressed in Millimeters, is the Sum of
F - 30-6. Unstable Intertrochanteric Fracture Stabilized with a Cephalomedullary Nail (Cmn)
F - 30-7. A 55-Year-Old Man Who Fell and Sustained a Displaced Greater
31. Subtrochanteric Fractures
31. Subtrochanteric Fractures
F - 31-1. Koch Diagram Showing the Compression Stress on the Medial Side
F - 31-2. The Deforming Force by the Unopposed Pull of the Iliopsoas
F - 31-3. An Atypical Subtrochanteric Fracture; Arrow Points to Medial Spike
F - 31-4. A Subtrochanteric Fracture Fixed with a Fixed Angle Blade Plate
F - 31-5. Nonunion and Failure of Hardware through the Lag Screw Hole
F - 31-6. Varus Malreduction of a Subtrochanteric Femur Fracture
32. Femoral Shaft Fractures
32. Femoral Shaft Fractures
F - 32-1. Deforming Muscle Forces on the Femur; Abductors (A), Iliopsoas (B),
F - 32-2. Cross-Sectional Diagram of the Thigh Demonstrates the Three Major Compartments
F - 32-3. Winquist and Hansen Classification of Femoral Shaft Fractures
F - 32-4. Comminuted Femur Fracture Stabilized with a Bridging External Fixator
F - 32-5. The Femur Fracture in Figure 32.4 Was Eventually Definitively Stabilized
33. Distal Femur Fractures
33. Distal Femur Fractures
F - 33-1. Schematic Drawing of the Distal Femur
F - 33-2. Anatomy of the Distal Femur
F - 33-3. Alignment of the Lower Extremity
F - 33-4. Lateral View Showing Typical Distal Femur Fracture Pattern and Muscle
34. Knee Dislocation (Femorotibial)
34. Knee Dislocation (Femorotibial)
F - 34-1. Clinical Appearance of a Posterior Knee Dislocation
F - 34-2. Classification of Knee Dislocations Based on Displacement of the Tibia
F - 34-3. Lateral Radiograph of a Posterior Right Knee Dislocation with an
35. Patella and Extensor Mechanism Injuries
F - 35-1. Soft Tissue Anatomy of the Patella
F - 35-2. Classification of Patella Fractures
F - 35-3. Transverse Patella Fracture Fixed with a Kirschner Wire Tension Band
F - 35-4. Comminuted Patella Fracture Fixed with Dorsal Plate
F - 35-5. Patellofemoral Views
F - 35-6. Insall-Salvati Ratio for Measuring Patellar Height is Determined by Dividing
F - 35-7. Suture Anchor Repair of a Quadriceps Tendon Rupture
Patella Dislocation
Patella Tendon Rupture
Patellar Fractures
Quadriceps Tendon Rupture
36. Tibial Plateau Fractures
36. Tibial Plateau Fractures
F - 36-1. Stress Exam Demonstrating Medial Collateral Ligament Incompetence in Conjunction with
F - 36-2. Schatzker Classification of Tibial Plateau Fractures
F - 36-3. Hohl and Moore Classification of Tibial Plateau Fractures
F - 36-4. Arthroscopic Evaluation of a Schatzker II Tibial Plateau Fracture Demonstrating
F - 36-5. Schatzker II Fracture Open Reduction of the Joint and Plate
37. Tibia and Fibula Shaft Fractures
37. Tibia and Fibula Shaft Fractures
F - 37-1. The Anatomy of the Tibial and Fibular Shaft
F - 37-2. The Four Compartments of the Leg
F - 37-3. A 19-Year-Old Female Ballet Dancer with Chronic Anterior Tibial Pain
38. Injuries about the Ankle
Achilles Tendon Rupture
F - 38-1. Bony Anatomy of the Ankle
F - 38-10. Operative Fixation of Orthopaedic Trauma Association C3 Pilon Fracture
F - 38-11. The Thompson Test for Continuity of the Gastrocnemius-Soleus Complex
F - 38-2. Three Views of the Tibiofibular Syndesmotic Ligaments
F - 38-3. Medial Collateral Ligaments of the Ankle
F - 38-4. Lateral Collateral Ligaments of the Ankle and the Anterior Syndesmotic
F - 38-5. X-Ray Appearance of the Normal Ankle on Mortise View
F - 38-6. Schematic Diagram and Case Examples of Lauge-Hansen Supination-External Rotation and
F - 38-7. Schematic Diagram and Case Examples of Lauge-Hansen Pronation-External Rotation and
F - 38-8. (A)Schematic Diagram of the Danis-Weber Classification of Ankle Fractures: Infrasyndesmotic
F - 38-9. Example of a Chronically Dislocated Ankle Secondary to Failure to
Lateral Ankle Ligament Injuries
Peroneal Tendon Subluxation
Plafond (Pilon) Fractures
Rotational Ankle Fractures
Syndesmosis Sprains
39. Calcaneus Fractures
39. Calcaneus Fractures
F - 39-1. The Bohler Angle
F - 39-2. Angle of Gissane
F - 39-3. Photograph of the Radiographic Technique for Obtaining the Harris or
F - 39-4. CT Scan Demonstrating Involvement of the Posterior Facet
F - 39-5. Mechanism of Injury According to Essex-Lopresti
F - 39-6. The Sanders CT Scan Classification of Calcaneal Fractures
F - 39-7. Schematic Lateral View of Anterior Process Fracture
F - 39-8. Essex-Lopresti Technique As Modified by Tornetta
40. Talus Fractures
40. Talus Fractures
F - 40-1. Superior and Inferior Views of the Talus (Stippling Indicates the
F - 40-2. Canale and Kelly View of the Foot
F - 40-3. The Three Patterns of Talar Neck Fractures As Described by Hawkins
F - 40-4. Hawkins Type II Talar Neck Fracture
F - 40-5. (A)Hawkins Type III Talar Neck Fracture Initial Injury.(B)Following Orif of
F - 40-6. Talus Body Fractures
F - 40-7. A 40-Year-Old Man Involved in a Motorcycle Accident Had an
41. Fractures of the Midfoot and Forefoot
Cuboid Fractures
Cuneiform Fractures
F - 41-1. Bony Anatomy of the Midfoot
F - 41-10. A Method of Closed Reduction for Displaced Proximal Phalanx Fractures
F - 41-2. Ligamentous Structure of the Midfoot
F - 41-3. The Present Popular Classification of Navicular Fractures is Composed of
F - 41-4. The Anatomy of the Tarsometatarsal Joints
F - 41-5. AP View of the Tarsometatarsal Joint Showing Normal Joint Alignment
F - 41-6. Medial Oblique View of the Tarsometatarsal Joint Showing Normal Joint
F - 41-7. The Common Classification Devised by Quenu and Kuss
F - 41-8. Myerson Classification of Lisfranc Fracture-Dislocations
F - 41-9. Three Zones of Proximal Fifth Metatarsal Fracture
Fractures of the Forefoot
Midtarsal (Chopart) Joint
Navicular Dislocation
Tarsal Navicular
Tarsometatarsal (Lisfranc) Joint
5. Pediatric Fractures and Dislocations
42. Pediatric Orthopaedic Surgery: General Principles
42. Pediatric Orthopaedic Surgery: General Principles
F - 42-1. Schematic Diagram of the Organization of the Physis
F - 42-2. Salter-Harris Classification of Physeal Fractures
F - 42-3. Peterson Classification of Physeal Fractures
43. Pediatric Shoulder
Acromioclavicular Joint Injuries
Clavicle Fractures
F - 43-1. Hyperextension or Rotation of the Ipsilateral Arm May Result in
F - 43-2. Anatomy of the Proximal Humerus
F - 43-3. Salter-Harris Classification of Physeal Fractures of the Proximal Humerus
F - 43-4. Sling and Swathe for Immobilization of Proximal Humeral Fracture
F - 43-5. (A)Cephalic Tilt View.(B)Apical Lordotic View
F - 43-6. Allman Classification of Clavicle Fractures
F - 43-7. Dameron and Rockwood Classification of Distal and Lateral Fractures of
F - 43-8. General Classification of Scapular and Glenoid Fractures
Glenohumeral Dislocations
Proximal Humerus Fractures
Scapula Fractures
44. Pediatric Elbow
44. Pediatric Elbow
F - 44-1. Ossification and Fusion of the Secondary Centers of the Distal Humerus
F - 44-2. Lateral Radiograph Lines of the Distal Humerus
F - 44-3. Elevated Anterior and Posterior Fat Pads
F - 44-4. Physeal Fractures of the Lateral Condyle
F - 44-5. Fracture Patterns
F - 44-6. Types of Valgus Injuries
F - 44-7. Patterson's Manipulative Technique
F - 44-8. Flexion-Pronation (Israeli) Reduction Technique
Specific Fractures
45. Pediatric Forearm
45. Pediatric Forearm
Distal Radius Fractures - Pediatric Forearm
F - 45-1. Deforming Muscle Forces in Both Bone Forearm Fractures
F - 45-2. The Normal Bicipital Tuberosity from Full Supination (90 Degrees) to
F - 45-3. Top: Traction and Counteraction of the Thumb is Used to
F - 45-4. While the Cast Hardens, It is Pressed Together by Both
F - 45-5. Bado Classification
F - 45-6. Type I Monteggia Equivalents: 1, Isolated Anterior Radial Head Dislocation;
F - 45-7. Walsh Classification of Galeazzi Fractures
F - 45-8. Acceptable Method of Closed Reduction of Distal Physeal Fractures of
F - 45-9. Three-Point Molding
Galeazzi Fracture
Monteggia Fracture
Radius and Ulna Shaft Fractures
T - 45-1. Acceptable Angular Corrections in Degrees
46. Pediatric Wrist and Hand
F - 46-1. The Age at the Time of Appearance of the Ossific
F - 46-2. Three Types of Scaphoid Fractures
F - 46-3. Appearance of Secondary Ossification Centers (A)
F - 46-4. Classification of Thumb Metacarpal Fractures
F - 46-5. Anatomy About the Distal Phalanx
F - 46-6. (A-D)Mallet-Equivalent Physeal Fracture Types
F - 46-7. Three Types of Extraphyseal Fractures of the Distal Phalanx
Injuries to the Carpus
Injuries to the Hand
47. Pediatric Hip Fractures and Dislocations
F - 47-1. The Transformation of the Preplate to Separate Growth Zones for
F - 47-2. Arterial Supply of the Proximal Femur
F - 47-3. Delbet Classification of Hip Fractures in Children
F - 47-4. Patterns of Avascular Necrosis of the Pediatric Hip
Pediatric Hip Fractures
Traumatic Dislocation of the Hip
48. Pediatric Femoral Shaft Fractures
48. Pediatric Femoral Shaft Fractures
F - 48-1. The Relationship of Fracture Level and Position of the Proximal
F - 48-2. Application of a 90-Degree/90-Degree Spica Cast
F - 48-3. (A)A 12-Year-Old Boy with Distal Left Femur Fracture Treated with
T - 48-1. Acceptable Angulation
49. Pediatric Knee
Distal Femoral Physeal Fractures
F - 49-1. The Salter-Harris Classification of Fractures Involving the Distal Femoral Physis
F - 49-2. Closed Reduction and Stabilization of a Salter-Harris Type I or
F - 49-3. Screw Fixation Following Closed or Open Reduction of a Salter-Harris
F - 49-4. Tethering of the Popliteal Artery by the More Distal Tibial
F - 49-5. Development of the Tibial Tubercle
F - 49-6. Modified Ogden Classification of Tibial Tuberosity Fractures in Children
F - 49-7. Classification of Tibial Spine Fractures
F - 49-8. Osteochondral Fractures Associated with Dislocation of the Right Patella
F - 49-9. The Q (Quadriceps) Angle is Measured from the Anterior Superior
Knee Dislocation
Osteochondral Fractures
Overview
Patella Dislocation
Patella Fractures
Proximal Tibial Fractures
T - 49-1. Imaging Studies in the Evaluation of Distal Femoral Physeal Fractures
T - 49-2. Classifications and Implications of Proximal Tibial Physeal Fractures
Tibial Spine (Intercondylar Eminence) Fractures
Tibial Tubercle Fractures
50. Pediatric Tibia and Fibula
50. Pediatric Tibia and Fibula
Diaphyseal Fractures of the Tibia and Fibula
F - 50-1. The Muscles in the Anterior and the Lateral Compartments of
F - 50-2. (A)An 8-Year-Old Child Who Sustained an Open Distal Tibial Metaphyseal
Fractures of the Distal Tibial Metaphysis
Proximal Tibial Metaphyseal Fractures
Stress Fractures
Toddler's Fracture
51. Pediatric Ankle
51. Pediatric Ankle
F - 51-1. Dias-Tachdjian Classification of Physeal Injuries of the Distal Tibia and
F - 51-2. Compression-Type Injury of the Tibial Physis
F - 51-3. Juvenile Tillaux Fracture
F - 51-4. Closure of the Distal Tibial Physis Begins Centrally (A) and
F - 51-5. Anatomy of a Two-Part Lateral Triplane Fracture (Left Ankle)
F - 51-6. Anatomy of a Three-Part Lateral Triplane Fracture (Left Ankle)
52. Pediatric Foot
Calcaneus
F - 52-1. Time of Appearance and Fusion of Ossification Centers of the Foot
F - 52-2. The Landmarks for Measuring the Bohler Angle are the Anterior
F - 52-3. Schmidt and Weiner Classification of Calcaneal Fractures in Children
F - 52-4. Illustration of the Tarsometatarsal Joints and Ligaments
F - 52-5. Quenu and Kuss Classification of Tarsometatarsal Injuries
F - 52-6. Method of Taping to Adjacent Toe (S) for Fractures or
Metatarsals
Phalanges
Talus
Tarsometatarsal (LISFRANC) Injuries
6. Intraoperative Imaging
53. Intraoperative Patient Positioning and Fluoroscopy for Common Fracture Surgeries
Acknowledgment
F - 53-1. (A)Image Intensifier Brought in from above Patient with Bump Beneath
F - 53-10. Enough Room is Left Between the Patient and the Image
F - 53-11. With the Patient Prone, the Injured Extremity is Placed on
F - 53-2. (A)Image Intensifier Brought in from Contralateral Side of Injury Enabling
F - 53-3. (A)The Patient is Positioned Lateral in a Beanbag with the
F - 53-4. With the Patient Translated to the Edge of the Bed,
F - 53-5. With the Patient's Extremity Centered on Radiolucent Hand Table, the
F - 53-6. (A,B)Setup and Positioning for Anterior Approaches with the Patient Supine
F - 53-7. (A,C)Patient's Contralateral Leg Taped to Metal Base of Fracture Table
F - 53-8. (A)With the Patient Supine, the Image Intensifier is Draped and
F - 53-9. (A,B)The Patient is Positioned Supine with a Bump Placed Under
Introduction
Lower Extremity
Upper Extremity
Front Matter
Dedication
Preface
Section Editors
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