Campbell Toc

Chapter 1 rg|ca| 1echn|qes and Approaches
Andrew n Crenshaw Ir

rg|ca| 1echn|qes 4
1ournlqueLs 4
8adlographs ln Lhe CperaLlng 8oom 6
oslLlonlng of Lhe aLlenL 6
Local reparaLlon of Lhe aLlenL 7
woooJ lttlqotloq 5olotloos 9

uraplng 9
utoploq tbe Jqes of tbe loclsloo 10

revenLlon of Puman lmmunodeflclency vlrus 1ransmlsslon 10
Speclal CperaLlve 1echnlques 11
llxotloo of 1eoJoo to 8ooe 11
llxotloo of tbe Osseoos Attocbmeot of 1eoJoo to 8ooe 13
8ooe Ctoftloq 14

rg|ca| Approaches 23
1oes 24
Apptoocb to tbe lotetpbolooqeol Iolots 24
Apptoocbes to tbe Metototsopbolooqeol Iolot of tbe Cteot 1oe 24
Apptoocb to tbe Metototsopbolooqeol Iolots of tbe lesset 1oes 23

Calcaneus 23
MeJlol Apptoocb 23
lotetol Apptoocb 23
u Apptoocb 23
kocbet Apptoocb (cotveJ L) 27

1arsus and Ankle 27
Aotetolotetol Apptoocb 27
Aotetlot Apptoocb 28
kocbet lotetol Apptoocb to tbe 1otsos ooJ Aokle 29
Olllet Apptoocb to tbe 1otsos 29
lostetolotetol Apptoocb to tbe Aokle 30
Aotetolotetol Apptoocb to tbe lotetol uome of tbe 1olos 30
lostetlot Apptoocb to tbe Aokle 31
MeJlol Apptoocbes to tbe Aokle 32

1lbla 32
MeJlol Apptoocb 33
lostetolotetol Apptoocb 33
lostetlot Apptoocb to tbe 5opetomeJlol keqloo of tbe 1lblo 33

llbula 33

knee 36
AotetomeJlol ooJ Aotetolotetol Apptoocbes 36
lostetolotetol ooJ lostetomeJlol Apptoocbes 40
MeJlol Apptoocbes to tbe koee ooJ 5oppottloq 5ttoctotes 42
1toosvetse Apptoocbes to Meolscl 43
lotetol Apptoocbes to tbe koee ooJ 5oppottloq 5ttoctotes 43
xteoslle Apptoocbes to tbe koee 48
lostetlot Apptoocbes 31

lemur 32
lotetol Apptoocb 33
lostetlot Apptoocb 36
MeJlol Apptoocb to tbe lostetlot 5otfoce of tbe lemot lo tbe lopllteol 5poce
38
lotetol Apptoocb to tbe lostetlot 5otfoce of tbe lemot lo tbe lopllteol 5poce
38
lotetol Apptoocb to tbe ltoxlmol 5boft ooJ tbe 1tocbootetlc keqloo 38

Plp 60
Aotetlot Apptoocbes 60
lotetol Apptoocbes 63
MeJlol Apptoocb 74

AceLabulum and elvls 73
Aotetlot Apptoocbes 73
xteoslle Acetobolot Apptoocbes 81
xteoJeJ lllofemotol Apptoocb 81

lllum 89
lschlum 90
Symphysls ubls 90
Sacrolllac !olnL 90

8oLh Sacrolllac !olnLs or Sacrum 91
Splne 92
SLernoclavlcular !olnL 92
Acromloclavlcular !olnL 92
Shoulder 92
AotetomeJlol Apptoocbes 92
Aotetlot Axllloty Apptoocb 94
ueltolJ5pllttloq Apptoocb 93
1toosoctomlol Apptoocb 93
lostetlot lovetteJ u Apptoocb 99

Pumerus 100
lostetlot Apptoocb to tbe ltoxlmol nometos 102
Apptoocbes to tbe ulstol nometol 5boft 103

Llbow 103
xteoslle lostetolotetol Apptoocb 108
lostetlot Apptoocb by Olectoooo Osteotomy 108
xteoslle lostetlot Apptoocb 109
lotetol Apptoocb 111
lotetol ! Apptoocb 112
MeJlol Apptoocb wltb oo Osteotomy of tbe MeJlol plcooJyle 112
MeJlol ooJ lotetol Apptoocb 113
Clobol Apptoocb 114

8adlus 113
lostetolotetol Apptoocb to tbe koJlol neoJ ooJ Neck 113
Apptoocb to tbe ltoxlmol ooJ MlJJle 1bltJs of tbe lostetlot 5otfoce 117
Aotetlot Apptoocb to tbe ltoxlmol 5boft ooJ lbow Iolot 117
Aotetlot Apptoocb to tbe ulstol nolf of tbe koJlos 117

ulna 117
Apptoocbes to tbe ltoxlmol 1bltJ of tbe uloo ooJ tbe ltoxlmol loottb of tbe
koJlos 117

WrlsL 122
uotsol Apptoocbes 122
volot Apptoocb 123
lotetol Apptoocb 123
MeJlol Apptoocb 124
Chapter 2 Magnet|c kesonance Imag|ng |n Crthopaed|cs

Dexter n W|tte

1ypes of magnet|c resonance |mag|ng scans 130
Contra|nd|cat|ons 132
Ioot and ank|e 132
1endon ln[urles
LlgamenL ln[urles
CLher dlsorders of Lhe fooL and ankle

nee 134
aLhologlcal condlLlons of Lhe menlscl 136
CruclaLe llgamenL ln[ury 138
CLher knee problems 138

n|p 140
CsLeonecrosls 142
1ranslenL osLeoporosls 142
1rauma 143

p|ne 144
lnLerverLebral dlsc dlsease 144
osLoperaLlve back paln 144
Splnal Lumors 147
Splnal Lrauma 147

ho|der 147
aLhologlcal condlLlons of Lhe roLaLor cuff 147
lmplngemenL syndromes 148
aLhologlcal condlLlons of Lhe labrum 148
CLher causes of shoulder paln 149

Wr|st and e|bow 149
Carpal llgamenL dlsrupLlons 130
CLher paLhologlcal condlLlons of Lhe hand and wrlsL 130
|bow 130

1mor |mag|ng 131
mmary 133
Chapter 3 Arthrodes|s of the Ank|e nee and n|p

kobert M |cker|ng

Ank|e 163
Approaches for ankle arLhrodesls 163
Aotetlot opptoocb 163
1toosmolleolot (ttoosflbolot) opptoocb 163
lostetlot opptoocb 163

reparaLlon of [olnL surfaces 163
llxaLlon of arLhrodesls 163
xtetool flxotloo 166
lotetool flxotloo 167

8one grafLlng 169
1echnlques 171
Attbtoscoplc ookle ottbtoJesls 171
1lblotolot ottbtoJesls 171
1lblocolcooeol ottbtoJesls 181

nee 187
lndlcaLlons and resulLs 187
1echnlques 188

n|p 193
lndlcaLlons and resulLs 193
1echnlques 196
AttbtoJesls wltb coocelloos sctew flxotloo 196

1oLal hlp arLhroplasLy afLer hlp arLhrodesls 202
ho|der
arthrodes|s 208
PlsLory 208
lndlcaLlons 209
oslLlon 211
Surglcal
Lechnlques 212
CompllcaLlons
218

|bow arthrodes|s 219
lndlcaLlons 219
Surglcal Lechnlques 219
CompllcaLlons 223

Wr|st arthrodes|s 224
PlsLory 224
lndlcaLlons 224
oslLlon 224
Surglcal Lechnlques 223
CompllcaLlons 228

Chapter S 1ota| Ank|e Arthrop|asty
e N Ish|kawa

Genera| pr|nc|p|es 233
aLlenL selecLlon 233
reoperaLlve deformlLy 233

Cperat|ve techn|qe 236
Comp||cat|ons 237
lnLraoperaLlve 237
Molollqomeot 237
ltoctote 238
1eoJoo lojoty 238

osLoperaLlve 238
5yoJesmotlc oooooloo 238
woooJ ptoblems 238
lofectloo 238
compooeot lostoblllty ooJ lysls 238

pec|f|c |mp|ants and otcomes 238
AglllLy LoLal ankle arLhroplasLy 238
Scandlnavlan LoLal ankle replacemenL 239
8euchelappas LoLal ankle arLhroplasLy 239

Conc|s|on 240
Chapter 6 Arthrop|asty of the nee
Iohn k Crockare|| Ir Iames L Gyton

Modern prosthes|s evo|t|on and des|gn 241
varusvalgus consLralned prosLheses 243
Moblle bearlng prosLheses 244
unlcomparLmenLal prosLheses 244
Plnged lmplanLs 243
rosLhesls sysLems 243

|omechan|cs of knee arthrop|asty 246
klnemaLlcs 246
kole of tbe postetlot ctoclote llqomeot lo totol koee
ottbtoplosty 247
Axlol ooJ tototloool ollqomeot of tbe koee 249
lotellofemotol jolot 230

olyeLhylene lssues 233
ComponenL flxaLlon 233

Ind|cat|ons and contra|nd|cat|ons for tota| knee arthrop|asty 236
1rlcomparLmenLal knee replacemenL 236
unlcondylar knee arLhroplasLy 236
lndlcaLlons for paLellar resurfaclng 237
lndlcaLlons for slmulLaneous bllaLeral LoLal knee arLhroplasLy 238

kes|ts of pr|mary tota| knee arthrop|asty 238
luncLlonal and radlographlc ouLcome measures 238
rosLhesls survlval 239

reoperat|ve eva|at|on 261
AnesLheLlc opLlons 261

rg|ca| techn|qe for pr|mary tr|compartmenta| knee rep|acement
262
lottomeJolloty ooJ exttomeJolloty ollqomeot losttomeototloo 267
compotetosslsteJ ollqomeot tecbolpoe 267
LlgamenLous balanclng 268
ManagemenL of bone deflclency 272
aLellofemoral Lracklng 273
Wound closure 276
osLoperaLlve managemenL 278

rg|ca| prob|ems re|at|ve to spec|f|c d|sorders 278
revlous hlgh Llblal osLeoLomy 278
revlous paLellecLomy 279
neuropaLhlc arLhropaLhy 280
CLher medlcal condlLlons 280

Comp||cat|ons of tota| knee arthrop|asty 281
1hromboembollsm 281
lnfecLlon 282
aLellofemoral compllcaLlons 286
neurovascular compllcaLlons 289
erlprosLheLlc fracLures 290

kev|s|on tota| knee arthrop|asty 291
AsepLlc fallure of prlmary LoLal knee arLhroplasLy 291
Surglcal exposures for revlslon arLhroplasLy 294
ComponenL removal 296
8econsLrucLlon prlnclples 296
8esulLs of revlslon knee arLhroplasLy 299
Chapter 7 Arthrop|asty of the n|p

Iames W narkess Iohn k Crockare||

App||ed b|omechan|cs 314
lorces acLlng on Lhe hlp 314
SLress Lransfer Lo bone 313

Des|gn and se|ect|on of tota| h|p components 318
lemoral componenLs 318
lemotol stems oseJ wltb cemeot 321
cemeotless stems wltb potoos sotfoces 323
Noopotoos cemeotless femotol compooeots 326
5peclollzeJ ooJ costommoJe femotol compooeots 327

AceLabular componenLs 328
cemeoteJ ocetobolot compooeots 328
cemeotless ocetobolot compooeots 329
Altetootlve beotloqs 332

Ind|cat|ons for tota| h|p arthrop|asty 333
Contra|nd|cat|ons |n tota| h|p arthrop|asty 337
reoperat|ve eva|at|on 337
reoperat|ve rad|ographs 338
reparat|on and drap|ng 340
rg|ca| approaches and techn|qes 340
1oLal hlp arLhroplasLy Lhrough Lhe posLerolaLeral approach wlLh
posLerlor dlslocaLlon of Lhe hlp 343
lmplanLaLlon of cemenLless aceLabular componenLs 347
lmplanLaLlon of cemenLed aceLabular componenLs 349
lmplanLaLlon of cemenLless femoral componenLs 331
lmplanLaLlon of cemenLed femoral componenLs 333
Mlnlmally lnvaslve Lechnlques 339
8esurfaclng arLhroplasLy 361
1rochanLerlc osLeoLomy 364

rg|ca| prob|ems re|at|ve to spec|f|c h|p d|sorders 368
ArLhrlLlc dlsorders 368
Osteoottbtltls (ptlmoty ot secooJoty bypetttopblc ottbtltls
ot Jeqeoetotlve ottbtltls) 368
kbeomotolJ ottbtltls 369

CsLeonecrosls 369
roLruslo aceLabull 370
uevelopmenLal dysplasla 372
uwarflsm 379
osLLraumaLlc dlsorders 382
lemotol oeck ooJ ttocbootetlc ftoctotes ooJ oooooloos
382
Acetobolot ftoctotes 382

lalled reconsLrucLlve procedures 383
ltoxlmol femotol osteotomy ooJ Jefotmlty 383
AttbtoJesls ooJ ookylosls 386

MeLabollc dlsorders 388
loqet Jlseose 388
Coocbet Jlseose 389
5lckle cell ooemlo 389
cbtoolc teool follote 390
nemopblllo 390
lnfecLlous dlsorders 390

lyoqeolc ottbtltls 390
1obetcolosls 391

1umors 391
neuromuscular dlsorders 392

Comp||cat|ons 392
MorLallLy 392
PemaLoma formaLlon 392
PeLeroLoplc osslflcaLlon 393
1hromboembollsm 394
nerve ln[urles 396
vascular ln[urles 398
LlmblengLh dlscrepancy 399
ulslocaLlon and subluxaLlon 401
lracLures 406
1rochanLerlc nonunlon and mlgraLlon 411
lnfecLlon 414
Aotlblotlc ptopbyloxls 413
closslflcotloo 416
uloqoosls 416
Moooqemeot 417
kecoosttoctloo oftet lofectloo ooJ compooeot temovol
418

Loosenlng 420
lemotol looseoloq 420
Acetobolot looseoloq 423
uloqoosls 426

CsLeolysls 428
kev|s|on of tota| h|p arthrop|asty 430

lndlcaLlons and conLralndlcaLlons 431
reoperaLlve plannlng 431
Surglcal approach 432
5tem temovol 433
kemovol of o btokeo stem 438
kemovol of cemeot ftom tbe femot 440
kemovol of tbe cop ooJ cemeot ftom tbe ocetobolom 444

8econsLrucLlon of aceLabular deflclencles 446
covltoty Jeflclts 448
5eqmeotol Jeflclts 448

8econsLrucLlon of femoral deflclencles 433
5eqmeotol Jeflclts 437
covltoty Jeflclts 438
lemotol Jefotmlty 460
lemotol olloqtoft 460
ostoperat|ve management of tota| h|p arthrop|asty 464

Chapter 8 Arthrop|asty of the ho|der and |bow
Ireder|ck M Azar Iames n Ca|andrcc|o

ho|der 483
PlsLory 483
AnaLomy and blomechanlcs 486
rosLhesls deslgn 487
Shoulder arLhroplasLy 489
loJlcotloos 489
coottoloJlcotloos 491
lteopetotlve ploooloq ooJ evolootloo 491

PemlarLhroplasLy 493
1oLal shoulder arLhroplasLy 306
8ooe qtoftloq of tbe qleoolJ 309

8everse shoulder arLhroplasLy 309
8ehablllLaLlon afLer shoulder arLhroplasLy 314
CompllcaLlons 316
lottoopetotlve compllcotloos 317
lostopetotlve compllcotloos 319

8evlslon arLhroplasLy 322
CLher surglcal opLlons for falled LoLal shoulder arLhroplasLy
324
nemlottbtoplosty 324
kesectloo ottbtoplosty 324
Cleoobometol ottbtoJesls 324

|bow 324
PlsLory 324
1ypes of arLhroplasLy 328
ubtlJemeot ottbtoplosty 330
lotetposltloool (fosclol) ottbtoplosty 330
kesectloo ottbtoplosty of tbe toJlol beoJ 330
lmploot ottbtoplosty 332

CompllcaLlons 333

lndlcaLlons 334
kesectloo ottbtoplosty 334

ConLralndlcaLlons 333
1echnlques 333
kevlsloo ooJ solvoqe sotqety oftet lmploot ottbtoplosty
348
art IV AMU1A1ICN

Chapter 9 Genera| r|nc|p|es of Amptat|ons
kobert neck Ir

Inc|dence and |nd|cat|ons 362
erlpheral vascular dlsease 362
1rauma 362
8urns 364
lrosLblLe 364
lnfecLlon 363
1umors 366

rg|ca| pr|nc|p|es of amptat|ons 367
ueLermlnaLlon of ampuLaLlon level 367
1echnlcal aspecLs 368
5klo ooJ moscle flops 368
nemostosls 369
Netves 369
8ooe 369

Cpen ampuLaLlons 369
osLoperaLlve care 369

Comp||cat|ons 371
PemaLoma 371
lnfecLlon 371
Wound necrosls 371
ConLracLures 372
aln 372
uermaLologlcal problems 373

Amptat|ons |n ch||dren 373
Chapter 10 Amptat|ons of the Ioot
Dav|d k k|chardson

1oe amptat|ons 379
M|dfoot amptat|ons 387
n|ndfoot and ank|e amptat|ons 390
Chapter 11 Amptat|ons of the Lower xtrem|ty
Marc M|ha|ko antos Mart|nez

Ioot and ank|e amptat|ons 600
1ranst|b|a| (be|owknee) amptat|ons 600
nonlschemlc llmbs 600
lschemlc llmbs 603

D|sart|c|at|on of the knee 603
1ransfemora| (aboveknee) amptat|ons 608
nonlschemlc llmbs 609
lschemlc llmbs 611
Chapter 12 Amptat|ons of the n|p and e|v|s

Marc I M|ha|ko

D|sart|c|at|on of the h|p 613
nem|pe|vectomy 617
Chapter 13 Amptat|ons of the Upper xtrem|ty
ev|n C|eve|and

nand amptat|ons 623
Wr|st amptat|ons 623
Iorearm amptat|ons (transrad|a|) 626
|bow d|sart|c|at|on 629
Arm amptat|ons (transhmera|) 629
ho|der amptat|ons 630
Ioreqarter amptat|on 634
Chapter 14 Amptat|ons of the nand
Iames n Ca|andrcc|o

Cons|derat|ons for amptat|on 639
r|nc|p|es of amptat|on of the f|ngers 641
Amptat|ons of f|ngert|ps 641
lree skln grafL 643
Cross flnger flaps 647

Amptat|ons of s|ng|e f|ngers 630
lndex flnger 630
Mlddle or rlng flnger ray ampuLaLlons 632
kloq floqet ovolsloo lojotles 633

LlLLle flnger ampuLaLlons 633

Amptat|ons of the thmb 633
Amptat|ons of m|t|p|e d|g|ts 636
a|nf| amptat|on stmp 638
keconstrct|ons after amptat|on 638
8econsLrucLlon afLer ampuLaLlon of Lhe hand 638
8econsLrucLlon afLer ampuLaLlon of mulLlple dlglLs 660
8econsLrucLlon of Lhe Lhumb 660
art V INIC1ICN

Chapter 1S Genera| r|nc|p|es of Infect|on
ev|n C|eve|and

t|o|ogy 673
aLlenLdependenL facLors 673
Nottltloool stotos 673
lmmoooloqlcol stotos 676

SurgeondependenL facLors 677
5klo ptepototloo 677
Opetotloq toom eovltoomeot 677
ltopbyloctlc ootlblotlc tbetopy 678

D|agnos|s 678
LaboraLory sLudles 678
lmaglng sLudles 679
CulLure sLudles 683

1reatment 684
nman |mmnodef|c|ency v|rs 683
ulagnosLlc LesLs 686
ConflrmaLory LesLs 686
MusculoskeleLal syndromes ln human lmmunodeflclency vlrus
lnfecLed paLlenLs 686
8lsks and prevenLlon 687
Chapter 16 Csteomye||t|s
Gregory D Dabov

C|ass|f|cat|on 693
Acte hematogenos osteomye||t|s 696
ulagnosls 697
1reaLmenL 698

bacte hematogenos osteomye||t|s 700
8rodle abscess 701

Chron|c osteomye||t|s 702
ClasslflcaLlon 702
ulagnosls 703
1reaLmenL 704
lolymetbyl metboctylote ootlblotlc beoJ cbolos 707
8loJeqtoJoble ootlblotlc Jellvety systems 708
closeJ soctloo Jtolos 709
5ofttlssoe ttoosfet 709
lllzotov tecbolpoe 709
nypetbotlc oxyqeo tbetopy 709

c|eros|ng osteomye||t|s of Garr 709
kes|da| stage of osteomye||t|s 710
atho|og|ca| fractre |n osteomye||t|s 710
Chron|c recrrent m|t|foca| osteomye||t|s 710
Csteomye||t|s after pnctre wond of the foot 711
Anaerob|c osteomye||t|s 711
Csteomye||t|s of spec|f|c reg|ons 711
Calcaneus 711
ulsLal Lhlrd of Lhe femur 712
lllum 713
1teotmeot Jotloq tbe ocote pbose 713
1teotmeot Jotloq tbe cbtoolc pbose 713

lschlum and publs 713
Splne 713

kesect|on or exc|s|on for osteomye||t|s 713
8esecLlon of Lhe Larsals 714

Amptat|on for osteomye||t|s 716
Chapter 17 Infect|os Arthr|t|s
Ieffrey A D|abach Ash|ey L ark

C||n|ca| presentat|on 723
Imag|ng std|es 724
athogenes|s 723
M|crob|o|ogy 723
1reatment 726
1arsa| [o|nts 728
Ank|e 728
AsplraLlon 728
uralnage 728

nee 729
AsplraLlon 729
uralnage 729

n|p 732
AsplraLlon 733
uralnage 734
Attbtoscoplc Jtolooq 736

CompllcaLlons of acuLe sepLlc arLhrlLls of Lhe hlp 736
lotboloqlcol Jlslocotloo 736
Osteomyelltls 737
lelvlc obscess 737
letslsteot lofectloo 738

acro|||ac [o|nt 739
p|ne 740
ternoc|av|c|ar and acrom|oc|av|c|ar [o|nts 740
ho|der 740
AsplraLlon 740
uralnage 740
Attbtoscoplc Jtolooq 741

|bow 741
AsplraLlon 741
uralnage 741
Wr|st 742

AsplraLlon 742
uralnage 742

Cperat|ons to correct deform|t|es after sept|c arthr|t|s 743
Ankle 743
knee 743
Plp 747
Attbtoplosty 747
Opetotloos to stoblllze tbe blp 747
Opetotloos to cottect Jefotmlty 748
Opetotloos to epoollze leq leoqtbs 730
Chapter 18 1berc|os|s and Cther Unsa| Infect|ons

Marc I M|ha|ko antos I Mart|nez

1berc|os|s 733
PlsLorlcal epldemlology 733
norLh Amerlcan demographlcs 733
MusculoskeleLal lnvolvemenL 734
Cllnlcal presenLaLlon 734
LaboraLory flndlngs 734
lmaglng 733
nonoperaLlve LreaLmenL of appendlcular Luberculous
lnfecLlons 733
CperaLlve LreaLmenL 733
loot 736
Aokle 739
koee 739
nlp 739
5octollloc jolot 761
lobls 761
clovlcle 761
5boolJet 761
lbow 762
wtlst ooJ booJ 762

1uberculosls of long bones 763
Ampototloo 763

Cther nsa| |nfect|ons 764
nonLuberculous mycobacLerlal lnfecLlons 764
8rucellosls 764
1yphold fever 764
Syphllls 764
Anaeroblc lnfecLlons 763
vlral osLelLls and arLhrlLls 763
AcLlnomycosls 763
Lyme dlsease 763
lungal lnfecLlon 763
Coccldloldomycosls 766
8lasLomycosls 766
PlsLoplasmosls 766
CrypLococcosls 766
SporoLrlchosls 767
Lchlnococcosls 767
art VI 1UMCk

Chapter 19 Genera| r|nc|p|es of 1mors
kobert neck Ir

D|agnost|c eva|at|on 773
Ceneral approach Lo musculoskeleLal neoplasms 773
MeLasLases of unknown orlgln 777
SLaglng 778
8lopsy 780

Ad[vant treatment 781
8adlaLlon Lherapy 781
ChemoLherapy 784

r|nc|p|es of srgery 783
AmpuLaLlon versus llmb salvage 783
Marglns 787
CureLLage 788
8esecLlon and reconsLrucLlon 791
ConslderaLlons for pedlaLrlc paLlenLs 793

rg|ca| techn|qes 793
upper exLremlLy 793
elvls 813
Lower exLremlLy 824
8oLaLlonplasLy 840
Chapter 20 en|gn one 1mors and Nonneop|ast|c Cond|t|ons

|m|at|ng one 1mors
kobert neck Ir

oneform|ng tmors833
CsLeold osLeoma 833
8one lsland 837

Cart||age |es|ons838
Chondroma 838
CsLeochondroma 860

I|bros |es|ons862
nonosslfylng flbroma 862
CorLlcal desmold 863
8enlgn flbrous hlsLlocyLoma 863
llbrous dysplasla 863
CsLeoflbrous dysplasla 864
uesmoplasLlc flbroma 863

Cyst|c |es|ons866
unlcameral bone cysL 866
Aneurysmal bone cysL 868
lnLraosseous gangllon cysL 870
Lpldermold cysL 870

Iatty tmors871
Llpoma 871

Vasc|ar tmors871
Pemangloma 871

Cther nonneop|ast|c |es|ons871
ageL dlsease 871
8rown Lumor" of hyperparaLhyroldlsm 873
8one lnfarcL 873
CsLeomyellLls 873
SLress fracLure 873
osLLraumaLlc osLeolysls 876
Chapter 21 en|gn]Aggress|ve 1mors of one

kobert neck Ir

G|ant ce|| tmor 883
Chondrob|astoma 886
Chondromyxo|d f|broma 889
Csteob|astoma 892
Langerhans ce|| h|st|ocytos|s 893
Chapter 22 Ma||gnant 1mors of one
kobert neck Ir

Csteosarcoma 901
Chondrosarcoma 907
w|ng sarcoma 910
Chordoma 913
Adamant|noma 913
Ma||gnant vasc|ar tmors 916
Ma||gnant f|bros h|st|ocytoma and f|brosarcoma 917
M|t|p|e mye|oma and p|asmacytoma 917
Lymphoma 920
Metastat|c carc|noma 923
Chapter 23 oft1|sse 1mors
kobert neck Ir

en|gn tmors and tmor||ke |es|ons 940
laLLy Lumors 940
nerve sheaLh Lumors 940
Synovlal leslons 942
vascular leslons 942
llbrous leslons 946

Ma||gnant tmors 946
MallgnanL flbrous hlsLlocyLoma 946
Llposarcoma 949
Synovlal sarcoma 930
llbrosarcoma 930
LplLhellold sarcoma 930
uermaLoflbrosarcoma proLuberans 930
8habdomyosarcoma 930
MallgnanL perlpheral nerve sheaLh Lumor 932
LxLraskeleLal osLeosarcoma 933
LxLraskeleLal Lwlng sarcoma 933
LxLraskeleLal chondrosarcoma 933
art VII NCN1kAUMA1IC CI11IU DICkDk

Chapter 24 Nontramat|c oft1|sse D|sorders
ev|n C|eve|and

Msc|e contractres 963
Cuadrlceps conLracLure of lnfancy and chlldhood 963
1teotmeot 964

uelLold conLracLure 966
CongenlLal LorLlcollls 966

napp|ng syndromes 966
knee 966
Plp 967
xtetool Jetooqemeot 967
lotetool Jetooqemeot 968
lottoottlcolot Jetooqemeot 969

Shoulder 969
Scapula 970
1rlceps Lendon 971

a|nf| paraart|c|ar ca|c|f|cat|ons 971
1end|n|t|s and brs|t|s 972
knee 973
ltepotellot botsltls 973
1lblol collotetol llqomeot flbtosltls ooJ botsltls 974
llbolot collotetol llqomeot botsltls 974
loftopotellot botsltls 973
lopllteol cyst (8oket cyst) 973

Plp 979
8otsltls ossocloteJ wltb qloteos moxlmos moscle 979

Splne 981
Shoulder 981
5obJeltolJ ot soboctomlol botsltls 981
5obscopolotls botsltls 981
8lclpltol teoosyoovltls 981

Llbow 983
Olectoooo botsltls 983
koJlobometol botsltls 983
Chapter 2S M|sce||aneos Nontramat|c D|sorders

Gregory Dabov

Chron|c synov|t|s 987
SynovecLomy 988

khemato|d arthr|t|s 988
AdulLonseL rheumaLold arLhrlLls 988
!uvenlle rheumaLold arLhrlLls 990
looL 992
Ankle and subLalar [olnL 992
knee 992
Attbtoscoplc syoovectomy 992
ltoxlmol tlblol osteotomy 994
AttbtoJesls 994
Attbtoplosty ot tecoosttoctloo 994

Plp 993
Splne 996
upper exLremlLy 996
5boolJet 997
lbow 998
wtlst ooJ floqets 999

Csteoarthr|t|s 999
looL and ankle 1000
knee 1000
ubtlJemeot 1000
OsteocbooJtol ooJ ootoloqoos cbooJtocyte
ttoosploototloo 1002
ltoxlmol tlblol osteotomy 1002
ulstol femotol osteotomy 1014
Attbtoplosty 1016
AttbtoJesls 1017
lotellofemotol jolot 1017

Plp 1019
ltoxlmol femotol osteotomy 1019
nooqloq blp opetotloo 1029
kesotfocloq ottbtoplosty 1030
1otol blp ottbtoplosty 1031
AttbtoJesls 1031

Splne 1031
Shoulder 1031
Llbow 1031
WrlsL 1032
!olnLs of Lhe hand 1032

Csteonecros|s 1032
lemoral head 1032
uloqoosls 1033
1teotmeot 1034

Pumeral head 1041

Id|opath|c trans|ent osteoporos|s 1041
Neropath|c arthropathy (Charcot [o|nt) 1042
looL 1043
Ankle 1043
knee 1043
Plp 1044
Splne 1043
Shoulder 1043

Intrape|v|c protrs|o acetab|| (Ctto pe|v|s or arthrokatadys|s) 1043
Cste|t|s pb|s 1046
volume ll

art VIII CCNGNI1AL ANCMALI

Chapter 26 Congen|ta| Anoma||es of the Lower xtrem|ty
Iames n eaty

o|ydacty|y 1063
yndacty|y 1064
Macrodacty|y 1064
C|eft foot (part|a| adacty|y) 1067
Contractre or ang|at|on of the toes 1070
Congen|ta| ha||x vars 1072
Congen|ta| metatarss addcts 1074
1reaLmenL 1077

Congen|ta| c|bfoot (ta||pes eq|novars) 1079
8adlographlc evaluaLlon 1081
ClasslflcaLlon 1082
nonoperaLlve LreaLmenL 1083
loosetl costloq tecbolpoe fot cottectloo of clobfoot
Jefotmlty 1084

lostetomeJlol teleose 1089

8eslsLanL clubfooL 1093
1tlple ottbtoJesls ooJ tolectomy fot oocottecteJ clobfoot
1097
uotsol booloo 1100

Congen|ta| vert|ca| ta|s 1100
Cllnlcal and radlographlc flndlngs 1100
1reaLmenL 1102

Congen|ta| ang|ar deform|t|es of the |eg 1103
Congen|ta| psedarthros|s of the f|b|a and t|b|a 1106
llbula 1106
1lbla 1106
closslflcotloo 1107
1teotmeot 1108

Constr|ct|ons of the |eg 1111
Congen|ta| hyperextens|on and d|s|ocat|on of the knee 1113
Congen|ta| d|s|ocat|on of the pate||a 1116
Congen|ta| def|c|enc|es of |ong bones 1117
1lblal hemlmella 1118
closslflcotloo 1119
1teotmeot 1120

llbular hemlmella 1123
closslflcotloo 1123
1teotmeot 1126

roxlmal femoral focal deflclency 1128
closslflcotloo 1128
1teotmeot 1131
Ampototloos 1136
Aokle Jlsottlcolotloo 1137

L|mb|ength d|screpancy 1140
Cllnlcal assessmenL 1140
1reaLmenL 1144
plpbysloJesls 1146
llmb sbotteoloq 1148
llmb leoqtbeoloq 1133
Chapter 27 Congen|ta| and Deve|opmenta| Anoma||es of the n|p and

e|v|s
Iames n eaty

Congen|ta| and deve|opmenta| dysp|as|a of the h|p 1180
ulagnosls and cllnlcal presenLaLlon 1181
1reaLmenL 1182
Newboto (blttb to 6 mootbs) 1182
lofoot (6 to 18 mootbs) 1183
1oJJlet (18 to J6 mootbs) 1197
cbllJ (J to 8 yeots) 1198
AJolesceot ooJ yoooq oJolt (8 yeots) 1220

Congen|ta| and deve|opmenta| coxa vara 1220
xstrophy of the b|adder 1222
AnLerlor lllac osLeoLomles and approxlmaLlon of Lhe symphysls publs
1222
Chapter 28 Congen|ta| Anoma||es of the 1rnk and Upper xtrem|ty
Iames n eaty

Congen|ta| e|evat|on of the scap|a (prenge| deform|ty) 1231
Congen|ta| msc|ar tort|co|||s 1233
Congen|ta| psedarthros|s of the c|av|c|e 1238
Congen|ta| d|s|ocat|on of the rad|a| head 1240
Congen|ta| psedarthros|s of the rad|s 1240
Congen|ta| psedarthros|s of the |na 1242
Congen|ta| rad|o|nar synostos|s 1242
art Ik C1CCnCNDkCI

Chapter 29 Csteochondros|s or p|phys|t|s and Cther M|sce||aneos
Affect|ons
1erry Cana|e

Csteochondros|s or ep|phys|t|s 1231
1racLlon eplphyslLls of Lhe flfLh meLaLarsal base (lselln dlsease) 1231
CsLeochondrosls of Lhe meLaLarsal head (lrelberg lnfracLlon) 1232
CsLeochondrosls of Lhe navlcular (khler dlsease) 1233
CsLeochondrlLls of Lhe ankle 1233
LplphyslLls of Lhe Llblal LuberoslLy (CsgoodSchlaLLer dlsease) 1233
CsLeochondrlLls dlssecans of Lhe knee 1236
CsLeochondrlLls dlssecans of Lhe paLella 1238
CsLeochondrosls of Lhe caplLellum (osLeochondrlLls dlssecans) 1260

LeggCa|verthes d|sease 1262
ulagnosls 1263
closslflcotloo 1263
8llotetol lovolvemeot 1264
lmoqloq evolootloo 1264

1reaLmenL 1263
8econsLrucLlve surgery ln LeggCalveerLhes dlsease 1273
volqos exteosloo osteotomy 1273
volqos flexloo lotetool tototloo osteotomy 1273
5belf ptoceJote 1276
cblotl osteotomy 1276
1tocbootetlc ovetqtowtb 1276

CsLeochondrlLls dlssecans of Lhe hlp 1281

nemoph|||a 1281
1oLal [olnL arLhroplasLy 1284
SynovecLomy 1284
ArLhrodesls 1286
CsLeoLomy 1286
CompllcaLlons of hemophllla 1286
ArLhroscoplc synovecLomy 1288

k|ckets osteoma|ac|a and rena| osteodystrophy 1289
1|b|a vara (|ont d|sease) 1292
CsLeoLomles 1297
neurovascular compllcaLlons of hlgh Llblal osLeoLomy 1304

Congen|ta| affect|ons 1304
CsLeogenesls lmperfecLa 1304
Moltlple osteotomles teollqomeot ooJ meJolloty ooll
flxotloo 1303
Osteotomy ooJ meJolloty oollloq wltb 1tlCeo ooll 1309

uwarflsm (shorL sLaLure) 1309
1raumaLlc physeal arresL from brldge of bone 1311
art k NkVCU 1M DICkDk IN CnILDkN

Chapter 30 Cerebra| a|sy
Ieffrey k awyer

t|o|ogy 1333
C|ass|f|cat|on 1333
Ceographlcal classlflcaLlon 1333
Mooopleqlo 1336
nemlpleqlo 1336
ulpleqlo 1336
OooJtlpleqlo 1336
1otol boJy 1336
Otbet types 1336
hyslologlcal classlflcaLlon 1336

5postlc 1336
AtbetolJ 1337
cbotelfotm 1337
klqlJ 1337
Atoxlc 1337
nypotoolc 1337
MlxeJ 1338

D|agnos|s 1338
rognosLlc facLors 1339
CalL analysls 1340

Assoc|ated cond|t|ons 1341
1reatment 1341
neurosurglcal lnLervenLlon 1343

n|p 1346
llexlon deformlLles 1347
AdducLlon deformlLles 1348
SubluxaLlon and dlslocaLlon 1331
votos Jetototloool osteotomy 1333

nee 1338
Plp and knee relaLlonshlps 1338
llexlon deformlLy 1338
8ecurvaLum of Lhe knee 1363
knee valgus 1363
aLella alLa 1363

Ioot 1366
Lqulnus deformlLy 1366
5otqlcol cottectloo of epoloos Jefotmlty 1366

varus or valgus deformlLy 1369
poloovotos Jefotmlty 1369
5pllt teoJoo ttoosfets 1372
poloovolqos Jefotmlty 1376

Calcaneus deformlLy 1378
Cavus deformlLy 1379
lorefooL adducLlon deformlLy 1379
Pallux valgus deformlLy 1380
Claw Loes 1380

p|nepe|v|c ob||q|ty and sco||os|s 1380
Upper extrem|ty 1381
Shoulder 1382
Llbow 1382
lorearm wrlsL and hand 1383

Ad|ts w|th cerebra| pa|sy 1383
Ad|t stroke pat|ents 1384
Lower exLremlLy 1384
Plp 1383
knee 1383
looL 1383
1ollpes epoloos 1383
1ollpes epoloovotos 1383
votos foot 1387
llooovolqos 1387
1oe flexloo 1387

upper exLremlLy 1387
5boolJet 1387

Llbow 1388
lbeool oetve block 1388
looctloool electtlcol oetve stlmolotloo 1388
Chapter 31 ara|yt|c D|sorders

W||||am C Warner Ir

o||omye||t|s 1401
aLhologlcal flndlngs 1402
Cllnlcal course and LreaLmenL 1402
Acote stoqe 1402
coovolesceot stoqe 1403
cbtoolc stoqe 1403

1endon Lransfers 1403
ArLhrodesls 1404
looL and ankle 1404
1eoJoo ttoosfets 1403
8ooy ptoceJotes (osteotomy ooJ ottbtoJesls) 1409
1eoJoo ttoosfet tecbolpoes 1417

knee 1423
llexloo coottoctote of tbe koee 1423
OooJtlceps potolysls 1423
Ceoo tecotvotom 1427
lloll koee 1429

1lbla and femur 1430
Plp 1430
llexloo ooJ obJoctloo coottoctotes of tbe blp 1430
lotolysls of tbe qloteos moxlmos ooJ meJlos moscles
1433
lotolytlc Jlslocotloo of tbe blp 1433

1runk 1437
lelvlc obllpolty 1437
lotolysls of tbe moscles of tbe obJomeo bock scopolo
ooJ oeck 1438

Shoulder 1439
1eoJoo ooJ moscle ttoosfets fot potolysls of tbe JeltolJ
1439
1eoJoo ooJ moscle ttoosfets fot potolysls of tbe
sobscopolotls soptoscopolotls soptosplootos ot
loftosplootos 1442
AttbtoJesls 1443

Llbow 1443
Moscle ooJ teoJoo ttoosfets to testote elbow flexloo 1443
Moscle ttoosfets fot potolysls of tbe ttlceps 1448

lorearm 1448
ltoootloo coottoctote 1448

WrlsL and hand 1430

Mye|omen|ngoce|e 1430
Lpldemlology 1430
AssoclaLed condlLlons 1431
nyJtocepbolos 1431
nyJtosytloqomyello 1432
AtoolJcblotl molfotmotloo 1432
1etbeteJ splool cotJ 1432
Otbet splool ooomolles 1432
utoloqlcol Jysfooctloo 1432
lotex bypetseosltlvlty 1432

ClasslflcaLlon 1433
CrLhopaedlc evaluaLlon 1434
rlnclples of orLhopaedlc managemenL 1434
Nooopetotlve moooqemeot 1433
Opetotlve moooqemeot 1433

looL 1436
poloos Jefotmlty 1436
clobfoot 1436
votos Jefotmlty 1437
covovotos Jefotmlty 1437
5oplootloo Jefotmlty 1438
colcooeos Jefotmlty 1438
nloJfoot volqos 1439
vettlcol tolos 1439
les covos Jefotmlty 1460
1oe Jefotmltles 1460

Ankle 1460
nemleplpbysloJesls of tbe Jlstol tlblol eplpbysls 1461

knee 1463
llexloo coottoctote 1464
xteosloo coottoctote 1466
votos ot volqos Jefotmlty 1467

Plp 1467
llexloo coottoctote 1467
llexlooobJoctlooextetool tototloo coottoctote 1468
xtetool tototloo coottoctote 1468
AbJoctloo coottoctote 1468
AJJoctloo coottoctote 1468
nlp sobloxotloo ooJ Jlslocotloo 1469
lelvlc obllpolty 1472

Splne 1472
5collosls 1472
kypbosls 1474

Arthrogrypos|s m|t|p|ex congen|ta 1474
1reaLmenL 1473
lowet exttemlty 1473
uppet exttemlty 1477

Scollosls 1480

rach|a| p|exs pa|sy 1480
Cllnlcal feaLures 1481
1reaLmenL 1482
Chapter 32 Neromsc|ar D|sorders

W||||am C Warner Ir

Genera| treatment cons|derat|ons 1300
lracLures 1300
CrLhoses 1300
SeaLlng sysLems 1300

D|fferent|at|on of msc|e d|sease from nerve d|sease 1301
PemaLologlcal sLudles 1301
LlecLromyographlc sLudles 1301
Muscle Llssue blopsy 1301

Msc|ar dystrophy 1304
uuchenne muscular dysLrophy 1304
lbyslcol exomlootloo 1304
MeJlcol tteotmeot 1304
OttbopoeJlc tteotmeot 1304

CLher varlanLs of muscular dysLrophy 1310
8ecket moscolot Jysttopby 1310
metyutelfoss moscolot Jysttopby 1311
llmbqltJle Jysttopby 1311
locloscopolobometol moscolot Jysttopby 1311
lofootlle focloscopolobometol moscolot Jysttopby 1312

CongenlLal dysLrophles 1313
MyoLonlc dysLrophy 1313

nered|tary motor and sensory neropath|es 1314
CharcoLMarle1ooLh dlsease (peroneal muscular aLrophy)
1314
covovotos foot Jefotmlty 1314
nlp Jysploslo 1319
5plool Jefotmltles 1319

CharcoLMarle1ooLh varlanLs 1319
lrledrelch aLaxla 1320
Splnal muscular aLrophy 1320
art kI IkAC1Uk AND DILCCA1ICN IN CnILDkN

Chapter 33 Iractres and D|s|ocat|ons |n Ch||dren
1erry Cana|e

hysea| |n[r|es 1333
Cpen fractres 1336
atho|og|ca| fractres 1336
Iractres at b|rth and fractres cased by ch||d abse 1336
Genera| pr|nc|p|es of operat|ve fractre treatment |n ch||dren 1338
nand and wr|st fractres d|s|ocat|ons and fractred|s|ocat|ons 1338
halangeal fracLures 1338
MeLacarpal fracLures 1340
1bomb metocotpol ftoctotes 1340

ulslocaLlons 1343
CLher fracLures and fracLuredlslocaLlons 1343

Iorearm fractres 1343
lracLures of Lhe dlsLal Lhlrd of Lhe forearm 1343
lracLures of Lhe mlddle Lhlrd of Lhe forearm 1346
lracLures of Lhe proxlmal Lhlrd of Lhe forearm 1348
ctoss ooloo (syoostosls) 1330
llostlc Jefotmotloo 1330
Mooteqqlo ooJ Coleozzl ftoctotes 1331

Iso|ated d|s|ocat|ons of the rad|a| head 1336
|bow [o|nt fractres and d|s|ocat|ons 1338
8adlal head and neck fracLures 1338
Clecranon fracLures 1363
lracLures of Lhe coronold process 1364
Llbow dlslocaLlons 1634
Acote Jlslocotloos 1364
cbtoolc tecotteot elbow Jlslocotloos 1363
OlJ ooteJoceJ elbow Jlslocotloos 1367

ulsLal humeral fracLures 1367
CaplLellar fracLures 1368
LaLeral condylar fracLures 1369
LsLabllshed nonunlon wlLh cublLus valgus 1374
Medlal eplcondylar fracLures 1373
Medlal condylar fracLures 1379
Supracondylar fracLures 1380
closeJ teJoctloo ooJ petcotooeoos plooloq 1383
Opeo teJoctloo ooJ lotetool flxotloo 1388
otly compllcotloos 1390
lote compllcotloos 1391

SeparaLlon of Lhe enLlre dlsLal humeral eplphysls 1398

Iractres of the shaft and prox|ma| end of the hmers 1399
Acrom|oc|av|c|ar d|s|ocat|ons 1601
Iractres and d|s|ocat|ons of the c|av|c|e 1602
p|ne fractres and d|s|ocat|ons 1604
Cervlcal splne 1604
Atlootooxlol ftoctoteJlslocotloos 1603
ltoctotes of tbe oJootolJ 1606
cJ7 ftoctotes ooJ Jlslocotloos 1606

1horaclc and lumbar splne fracLures 1606

e|v|c fractres 1607
Avulslon fracLures 1610
elvlc fracLures 1611
AceLabular fracLures 1611

n|p fractres |n ch||dren 1613
1ype l Lranseplphyseal separaLlons 1614
1ype ll Lranscervlcal fracLures 1616
1ype lll cervlcoLrochanLerlc fracLures 1617
1ype lv lnLerLrochanLerlc fracLures 1617
1reaLmenL recommendaLlons 1618

1ramat|c h|p d|s|ocat|ons |n ch||dren 1628
||pped cap|ta| femora| ep|phys|s 1630
1reaLmenL 1632
lo slto plo ot sctew flxotloo 1632
ltopbyloctlc plooloq of coottolotetol sllps 1636
closeJ teJoctloo 1636
Opeo teJoctloo 1637
8ooe peq eplpbysloJesls 1638
Osteotomy 1638
cbellectomy 1647

CompllcaLlons of sllpped caplLal femoral eplphysls 1647
Osteooectosls 1647
cbooJtolysls 1648
lemotol oeck ftoctote 1649
cootlooeJ sllpploq 1631

Iemora| fractres 1631
lemoral shafL fracLures (or dlaphyseal femoral fracLures)
1631
compllcotloos 1661

lracLures of Lhe dlsLal femoral physls 1662
compllcotloos 1666

nee fractres 1666
aLellar fracLures 1666
lracLures of Lhe lnLercondylar emlnence of Lhe Llbla 1668
1lblal LuberoslLy fracLures 1671
CsLeochondral fracLures 1673
lloaLlng knee ln[urles 1674

Acte d|s|ocat|ons of the knee 1674
1|b|a| and f|b|ar fractres 1673
roxlmal Llblal physeal fracLures 1673
roxlmal Llblal meLaphyseal fracLures 1678
Mlddle and dlsLal Llblal shafL fracLures 1680
ulsLal Llblal and flbular eplphyseal fracLures 1684
1rlplane fracLures 1689
1lllaux fracLures 1690
erlLalar dlslocaLlons 1693

Ioot fractres 1693
1alar fracLures 1693
1olot oeck ftoctotes 1693
ltoctotes of tbe Jome ooJ lotetol ptocess of tbe tolos 1696
OsteocbooJtol ftoctotes of tbe tolos 1696

Calcaneal fracLures 1699
1arsal fracLures 1699
MeLaLarsal and phalangeal fracLures 1701
art kII 1n IN

Chapter 34 p|na| Anatomy and rg|ca| Approaches
kaymond I Gardock|

Anatomy of the vertebra| co|mn 1729
Anatomy of the sp|na| [o|nts 1729
Anatomy of the sp|na| cord and nerves 1730
Anatomy of the cerv|ca| thorac|c and |mbar ped|c|es 1731
C|rc|at|on of the sp|na| cord 1733
rg|ca| approaches 1733
AnLerlor approaches 1733
Aotetlot opptoocb occlpot to cJ 1733
xteoJeJ moxlllotomy ooJ sobtotol moxlllectomy 1737
Aotetlot opptoocb cJ to c7 1741
Aotetlot opptoocb to tbe cetvlcotbotoclc jooctloo c7 to 11 1742
Aotetlot opptoocb to tbe tbotoclc sploe 1744
vlJeoosslsteJ tbotoclc sotqety 1746
Aotetlot opptoocb to tbe tbotocolombot jooctloo 1747
Aotetlot tettopetltooeol opptoocb l1 to l5 1747
Aotetlot ttoospetltooeol opptoocb to tbe lombosoctol jooctloo l5 to
51 1749
vlJeoosslsteJ lombot sotqety 1730

osLerlor approaches 1731
lostetlot opptoocb to tbe cetvlcol sploe occlpot to c2 1732
lostetlot opptoocb to tbe cetvlcol sploe cJ to c7 1732
lostetlot opptoocb to tbe tbotoclc sploe 11 to 112 1733
costottoosvetsectomy 1734
lostetlot opptoocb to tbe lombot sploe l1 to l5 1733
lostetlot opptoocb to tbe lombosoctol sploe l1 to soctom 1733
lostetlot opptoocb to tbe soctom ooJ soctollloc jolot 1737
Chapter 3S Iractres D|s|ocat|ons and IractreD|s|ocat|ons of the p|ne

George W Wood II

va|at|on of sp|na| |n[ry 1761
PlsLory 1761
hyslcal examlnaLlon 1762
neurologlcal evaluaLlon 1763
lmaglng evaluaLlon 1766
MulLlple splnal fracLures 1768
AssoclaLed sofLLlssue ln[ury 1769
Splnal cord syndromes 1769

mergency department management 1771
Cerv|ca| sp|ne |n[r|es 1772
ClasslflcaLlon 1772
comptesslve flexlooflve stoqes 1772
vettlcol comptesslootbtee stoqes 1773
ulsttoctlve flexloofoot stoqes 1773
comptesslve exteoslooflve stoqes 1773
ulsttoctlve exteoslootwo stoqes 1774
lotetol flexlootwo stoqes 1774

lnsLablllLy 1774
5ttetcb test 1773

1reaLmenL 1776
Nooopetotlve tteotmeot 1777
Opetotlve tteotmeot 1778

ln[urles Lo Lhe upper cervlcal splne (occlpuL Lo C2) 1781
ulslocotloos of tbe otlootoocclpltol jolot 1781
Atlos ftoctotes 1784
koptote of tbe ttoosvetse llqomeot 1783
kototy sobloxotloo of c1 oo c2 1787
Occlpltol cooJyle ftoctotes 1788
ueos ftoctote 1788
lotetool flxotloo of tbe oppet cetvlcol sploe 1792
1toomotlc spooJylollstbesls of tbe oxls (booqmoos
ftoctotes) 1793

ln[urles Lo Lhe lower cervlcal splne (C37) 1797
lostetlot llqomeotoos lojoty 1797
uollotetol focet Jlslocotloo 1797
ltoctotes of tbe vettebtol boJy 1798
lostetlot ooJ ootetlot cetvlcol fosloo wltb tlqlJ lotetool
flxotloo 1804

1horac|c and |mbosacra| fractres 1810
ClasslflcaLlon of Lhoracolumbar fracLures 1810
1lmlng of surgery 1813
uecompresslon 1813
uegree of canal sLenosls 1814
vettebtol comptessloo ftoctotes 1813
8ollooo kypboplosty 1817

Speclflc lnsLrumenLaLlon 1817
leJlcle sctew losttomeototloo 1817
Aotetlot lotetool flxotloo Jevlces 1821

acra| fractres and |mbosacra| d|s|ocat|on 1830
Chapter 36 Arthrodes|s of the p|ne
Iranc|s k Cam|||o

one grafts and arthrodes|s hea||ng 1831
AllografLs and auLografLs 1832
8one grafL exLenders 1832

Cerv|ca| sp|ne 1833
AnLerlor arLhrodesls 1833
Ceoetol compllcotloos 1834
lostopetotlve compllcotloos 1833

1ypes of anLerlor arLhrodesls of Lhe cervlcal splne 1836
Aotetlot occlpltocetvlcol ottbtoJesls by exttopbotyoqeol
exposote 1862
Aotetlot oppet cetvlcol ottbtoJesls 1863
llbolot sttot qtoft lo cetvlcol sploe ottbtoJesls wltb
cotpectomy 1864

osLerlor arLhrodesls 1863

Dorsa| and |mbar sp|ne 1863
osLerlor arLhrodesls 1866
nlbbs fosloo of tbe sploe 1866
lostetolotetol ot lotetttoosvetse fosloos 1867
lotetool flxotloo lo splool fosloo 1869
1teotmeot oftet postetlot ottbtoJesls 1870
lseoJottbtosls oftet splool fosloo 1870
Mlolmolly lovoslve postetlot lombot fosloo 1871

Lumbar lnLerbody arLhrodesls 1871
Aotetlot Jlsc exclsloo ooJ lotetboJy fosloo 1871
Mlolmolly lovoslve ootetlot fosloo 1873
Chapter 37 ed|atr|c Cerv|ca| p|ne

W||||am C Warner Ir

Anoma||es of the odonto|d 1879
ulagnosls 1881
8adlographlc flndlngs 1881
1reaLmenL 1882
c12 ttoosottlcolot sctew flxotloo 1884
Aotetlot cetvlcol opptoocbes 1884
nolovest lmmoblllzotloo 1898

as||ar |mpress|on 1899
1reaLmenL 1902

At|antoocc|p|ta| fs|on 1902
1reaLmenL 1903

||ppe|Ie|| syndrome 1904
5collosls 1904
keool ooomolles 1903
cotJlovoscolot ooomolles 1903
ueofoess 1903
5yokloesls 1903
kespltototy ooomolles 1903
5pteoqel Jefotmlty 1903
cetvlcol tlbs 1906
Cllnlcal flndlngs 1906

1reaLmenL 1908

At|antoax|a| rotatory sb|xat|on 1911
1reaLmenL 1912

Cerv|ca| |nstab|||ty |n Down syndrome 1913
neurologlcal flndlngs 1914
1reaLmenL 1914

Iam|||a| cerv|ca| dysp|as|a 1913
Congen|ta| anoma||es of the at|as 1913
Intervertebra| d|sc ca|c|f|cat|on 1913
Chapter 38 co||os|s and yphos|s
arney L Ireeman III

CCLICI 1922
Infant||e |d|opath|c sco||os|s 1922
1reaLmenL 1924

Iven||e |d|opath|c sco||os|s 1924
1reaLmenL 1923
Ctowloq toJ losttomeototloo 1926
losttomeototloo wltb fosloo 1928

Ado|escent |d|opath|c sco||os|s 1928
LLlology 1928
naLural hlsLory 1928
aLlenL evaluaLlon 1932
Meosotemeot of cotves 1934
vettebtol tototloo 1934
5oqlttol bolooce 1936
cotve pottetos 1937

Obsetvotloo 1941
Ottbotlc tteotmeot 1941
costloq 1941

lteopetotlve ptepototloo 1942
lottoopetotlve cooslJetotloos 1943
5otqlcol qools 1944

oster|or srger|es for |d|opath|c sco||os|s 1944
osLerlor fuslon 1946
8one grafLlng 1948
compllcotloos of booe qtoftloq 1949

osLerlor splnal lnsLrumenLaLlon 1949
MulLlhook segmenLal lnsLrumenLaLlon 1931
5otqlcol ploo 1931
losloo level ooJ book slte plocemeot 1931
nook slte ptepototloo ooJ plocemeot 1932
compllcotloos ooJ pltfolls lo moltlbook seqmeotol
losttomeototloo systems 1964

edlcle flxaLlon 1967
losettloo of lombot peJlcle sctews 1970
losettloo of tbotoclc peJlcle sctews 1971

CompllcaLlons of posLerlor scollosls surgery 1977
otly compllcotloos 1977

oster|or thoracop|asty 1979
CompllcaLlons and plLfalls 1982

Concave r|b osteotom|es 1983
Anter|or |nstrmentat|on for |d|opath|c sco||os|s 1983
CompllcaLlon and plLfalls of anLerlor lnsLrumenLaLlon 1992

Anter|or thoracop|asty 1993
V|deoass|sted thoracoscopy 1993
lLfalls and compllcaLlons 1996

ndoscop|c anter|or |nstrmentat|on of |d|opath|c sco||os|s 1997
Neromsc|ar sco||os|s 2006
Obsetvotloo 2007

lteopetotlve cooslJetotloos 2008
Opetotlve cooslJetotloos 2008
lostopetotlve cooslJetotloos 2009
lopoe toJ losttomeototloo wltb soblomloot wltloq 2010
5octopelvlc flxotloo 2011
uolt toJ seqmeotol splool losttomeototloo 2013
llloc flxotloo wltb llloc sctews 2019

Cerebral palsy 2019
closslflcotloo 2021

lrledrelch aLaxla 2024
CharcoLMarle1ooLh dlsease 2024
Syrlngomyella 2023
Splnal cord ln[ury 2026

ollomyellLls 2028
Splnal muscle aLrophy 2028

lamlllal dysauLonomla 2029
ArLhrogryposls mulLlplex congenlLa 2029
uuchenne muscular dysLrophy 2030
varlanLs of muscular dysLrophy oLher Lhan uuchenne Lype
2031

Congen|ta| sco||os|s 2031
ClasslflcaLlon 2032
aLlenL evaluaLlon 2032
lostetlot fosloo wltboot losttomeototloo 2036
lostetlot fosloo wltb losttomeototloo 2037
combloeJ ootetlot ooJ postetlot fosloos 2037
combloeJ ootetlot ooJ postetlot coovex
bemleplpbysloJesls (qtowtb ottest) 2039
nemlvettebto exclsloo 2041

1horaclc lnsufflclency syndrome 2044
xpoosloo tbotocoplosty 2046

nCI 2032
Anatomy 2032
cheermann d|sease 2032
ClasslflcaLlon 2032
LLlology 2033
ulfferenLlal dlagnosls 2036
Obsetvotloo 2036


Congen|ta| kyphos|s 2063
Cllnlcal and radlographlc evaluaLlon 2066
compllcotloos of opetotlve tteotmeot 2076

pondy|o|ys|s and spondy|o||sthes|s 2076
ClasslflcaLlon 2076
LLlology and naLural hlsLory 2078
1reaLmenL of acqulred spondylolysls 2081
kepolt of spooJylolytlc Jefect 2081
lostetolotetol fosloo 2082

1reaLmenL of developmenLal spondylollsLhesls 2082

1reaLmenL of severe (hlghdysplasLlc) spondylollsLhesls
2084
1reaLmenL of spondylopLosls 2092
l5 vettebtectomy 2092

yphosco||os|s 2092
Myelomenlngocele 2092
loclJeoce ooJ oototol blstoty 2093
cllolcol evolootloo 2093
koJloqtopblc floJloqs 2093
5collosls ooJ lotJosls 2093
kypbosls 2100

Sacral agenesls 2104
1teotmeot 2106

Unsa| cases of sco||os|s 2106
neuroflbromaLosls 2106
Moooqemeot of oooJysttopblc cotves 2107
Moooqemeot of Jysttopblc scollosls 2107
5collosls wltboot kypbosls 2107
kypboscollosls 2108
kypboscollosls wltb splool cotJ comptessloo 2108
1botoclc lotJoscollosls 2109
lostopetotlve moooqemeot 2109
compllcotloos of sotqety 2109

Marfan syndrome 2110
uloqoosls 2110

verLebral column Lumors 2113
cllolcol floJloqs 2113
koJloqtopblc evolootloo ooJ tteotmeot 2113
8lopsy 2113
8eolqo tomots of vettebtol colomo 2114
ltlmoty mollqooot tomots of vettebtol colomo 2118

osLlrradlaLlon splnal deformlLy 2119
loclJeoce 2119
koJloqtopblc floJloqs 2119
1teotmeot 2120
compllcotloos ooJ pltfolls 2120

CsLeochondrodysLrophy 2120
ulosttopblc Jwotflsm 2120
5pooJyloeplpbyseol Jysploslo 2121

CsLeogenesls lmperfecLa 2121
Aoestbeslo ptoblems 2122

Unsa| cases of kyphos|s 2123
osLlamlnecLomy splnal deformlLy 2123
1teotmeot 2124

SkeleLal dysplaslas 2126
AcbooJtoploslo 2126

Mucopolysaccharldoses 2126
Chapter 39 Lower ack a|n and D|sorders of Intervertebra| D|scs

e|th D W||||ams
Ash|ey L ark

Cverv|ew of d|sc degenerat|on and hern|at|on 2139
D|sc and sp|ne anatomy 2161
neural elemenLs 2162

Natra| h|story of d|sc d|sease 2164
Axlal lumbar paln 2163

D|agnost|c std|es 2166
8adlography 2166
Myelography 2166
CompuLed Lomography 2169
MagneLlc resonance lmaglng 2170
CLher dlagnosLlc LesLs 2171

In[ect|on std|es 2171
Lpldural corLlsone ln[ecLlons 2172
cetvlcol eplJotol lojectloo 2172
1botoclc eplJotol lojectloo 2174
lombot eplJotol lojectloo 2174

Zygapophyseal (faceL) [olnL ln[ecLlons 2177
cetvlcol focet jolot 2178
lombot focet jolot 2178
5octollloc jolot 2179

ulscography 2180
lombot Jlscoqtopby 2181
1botoclc Jlscoqtopby 2183
cetvlcol Jlscoqtopby 2183

Cerv|ca| d|sc d|sease 2184
Slgns and sympLoms 2186
ConflrmaLory lmaglng 2189
Aotetlot opptoocb to tbe cetvlcol Jlsc 2192
cetvlcol Jlsc ottbtoplosty 2193

1horac|c d|sc d|sease 2193
1reaLmenL resulLs 2196

Lmbar d|sc d|sease 2199
Ceoetol ptloclples fot mlctoJlscectomy 2206
oJoscoplc tecbolpoes 2210
AJJltloool exposote tecbolpoes 2210
lombot toot ooomolles 2211
kesolts of sotqety fot Jlsc betolotloo 2212
compllcotloos of Jlsc exclsloo 2212
ltee fot qtoftloq 2213
kepeot lombot Jlsc sotqety 2213
ulsc exclsloo ooJ fosloo 2216

Degenerat|ve d|sc d|sease and |nterna| d|sc derangement 2216
aLlenL selecLlon process 2218
ulffeteotlol splool ooestbetlc 2219
MoJlfleJ tecbolpoe 2220

Ia||ed sp|ne srgery 2223
Chapter 40 Infect|ons of the p|ne
Iranc|s k Cam|||o

|o|ogy of sp|na| |nfect|on 2238
Natra| h|story 2240
p|dem|o|ogy 2241
D|agnos|s 2242
ulagnosLlc Lechnlques 2243
koJloqtopbs 2243
compoteJ tomoqtopby 2243
Moqoetlc tesooooce lmoqloq 2244
koJlooocllJe scoooloq 2244
lobotototy stoJles 2243
uloqoostlc blopsy 2243


Nonoperat|ve treatment 2246
rognos|s 2246
pec|f|c |nfect|ons 2246
yogenlc lnfecLlons 2246
lofectloos lo cbllJteo 2246
ulsc spoce lofectloo lo oJolts 2247
plJotol spoce lofectloo 2248

osLoperaLlve lnfecLlons 2248
8rucellosls 2249
lungal lnfecLlons 2249
1uberculosls 2230
1teotmeot of tobetcolot splool lofectloo 2231
lott potopleqlo 2233
Atyplcol tobetcolot lofectloos 2234

Abscess dra|nage by anatom|ca| |eve| 2234
Cervlcal splne 2234
uorsal splne 2233
Lumbar splne and pelvlc dralnage 2237
utolooqe of psoos obscess 2237

rg|ca| treatment for tberc|os|s of the sp|ne 2239
CosLoLransversecLomy 2266
Chapter 41 Cther D|sorders of the p|ne
atr|ck M Cr|ee

p|na| stenos|s 2274
AnaLomy 2274
Cllnlcal evaluaLlon 2276
ulagnosLlc lmaglng 2277
koJloqtopby 2277
compoteJ tomoqtopby myeloqtopby 2278
Otbet Jloqoostlc stoJles 2280

plJotol stetolJ lojectloo 2281

ltloclples of splool steoosls sotqety 2282
AJjoceot seqmeot Jeqeoetotloo 2283
uecomptessloo 2284

Degenerat|ve spondy|o||sthes|s and sco||os|s 2288
lncldence 2288
koJloqtopby 2290
compoteJ tomoqtopby myeloqtopby ooJ moqoetlc
tesooooce lmoqloq 2290
ulscoqtopby 2290
Otbet stoJles 2291

plJotol stetolJ lojectloo 2291

uecomptessloo 2291
uecomptessloo ooJ fosloo 2291
lostetlot lombot lotetboJy fosloo ooJ ttoosfotomlool
lombot lotetboJy fosloo 2292
Aotetlot splool fosloo 2292
uecomptessloo ooJ combloeJ fosloo (J60Jeqtee fosloo)
2292

Ad|t |d|opath|c sco||os|s 2294
SaglLLal balance 2294
lncldence 2293
koJloqtopby 2296
ulscoqtopby 2296

lostetlot losttomeototloo ooJ fosloo 2297
Aotetlot splool losttomeototloo ooJ fosloo 2297
lostopetotlve moooqemeot 2298
combloeJ ootetlot ooJ postetlot fosloos 2298
New tecbolpoes 2300

Ad|t |sthm|c spondy|o||sthes|s 2301
lncldence 2301
AnaLomy 2301
8lomechanlcs 2302
koJloqtopby 2303
8ooe sclotlqtopby 2304
compoteJ tomoqtopby myeloqtopby 2304
ulscoqtopby 2304

plJotol stetolJ lojectloos 2303

Aotetlot lombot lotetboJy fosloo 2309

khemato|d arthr|t|s of the sp|ne 2311
koJloqtopby 2311
compoteJ tomoqtopby myeloqtopby ooJ moqoetlc
tesooooce lmoqloq 2312

Cervlcal lnsLablllLy 2312

Anky|os|ng spondy||t|s 2314
CsLeoLomy of Lhe lumbar splne 2316
5mltbletetseo osteotomy 2317
leJlcle sobttoctloo osteotomy 2317
qqsbell osteotomy 2317

CsLeoLomy of Lhe cervlcal splne 2318

1mors of sp|ne 2319
8enlgn Lumors 2319
5toblllty 2321
closslflcotloo 2321
lostetlot elemeot tomots 2322
vettebtol boJy tomots 2324

rlmary mallgnanL Lumors 2323
closslflcotloo 2323
Osteosotcomo 2323
wloq sotcomo 2323
cbotJomo 2326
Moltlple myelomo 2327

MeLasLaLlc Lumors 2327
lotbooootomy 2328
closslflcotloo 2328
lttoJlotloo 2328
art kIII Ck1 MDICIN

Chapter 42 Ank|e In[r|es
Dav|d k k|chardson

Acte ||gamentos |n[r|es 2333
AnaLomy 2333
ulagnosls 2333
lovetsloo ooJ evetsloo sttess tests 2333
Aotetopostetlot sttess test (ootetlot Jtowet slqo) 2336

1reaLmenL 2338
kepolt of ocote toptote of tbe JeltolJ llqomeot 2338
kepolt of ocote toptote of tbe llqomeots of tbe Jlstol
tlbloflbolot jolot 2339
kepolt of ocote toptote of tbe lotetol llqomeots 2360

Chronlc lnsLablllLy afLer ln[ury 2362
MeJlol tepolt of cbtoolc lostoblllty 2372
Interna| derangements 2372

CcculL leslons of Lhe Lalus 2373
Slnus Larsl syndrome 2373
CsLeochondral rldges of Lhe Lalus and Llbla (anLerlor and posLerlor
lmplngemenL syndromes) 2374
CsLeochondral leslons of Lhe Lalus (osLeochondral fracLure
Lranschondral fracLure dome fracLure of Lhe Lalus) 2377
Attbtoscoplc tteotmeot 2389
Chapter 43 nee In[r|es

kobert n M|||er III
Ireder|ck M Azar

Anatomy 2396
Csseous sLrucLures 2396
LxLraarLlcular Lendlnous sLrucLures 2396
LxLraarLlcular llgamenLous sLrucLures 2399
lnLraarLlcular sLrucLures 2410

Mechan|cs 2414
Interna| derangement 2416
Men|sc| 2417
luncLlon and anaLomy 2417
Menlscal heallng and repalr 2421
1ears of menlscl 2421
Mecboolsm of teot 2422
closslflcotloo 2422
uloqoosls 2423
uloqoostlc tests 2424
lmoqloq stoJles 2423
Attbtoscopy 2426
Opetotlve moooqemeot 2426
CLher condlLlons of menlscl 2432

cysts of meolscl 2432
ulscolJ meolscos 2433

Acte tramat|c |es|ons of ||gaments 2436
Ceneral conslderaLlons 2436
LLlology 2436
Mechanlsm 2436
LlgamenL heallng 2437
ClasslflcaLlon 2437
ulagnosls 2438
nlstoty ooJ pbyslcol exomlootloo 2438
koJloqtopblc exomlootloo 2448

ClasslflcaLlon of knee lnsLablllLy 2430
Ooeplooe lostoblllty 2431
kototy lostoblllty 2432
combloeJ lostobllltles 2432

1reaLmenL conslderaLlons 2433

Medlal comparLmenL (collaLeral) dlsrupLlons 2436
kecoosttoctloo wltb olloqtoft teoJoos 2473

LaLeral comparLmenL (collaLeral) dlsrupLlons 2473
kecoosttoctloo of lotetol compottmeot 2481
Aotetolotetol tototy lostoblllty 2496

Anter|or crc|ate ||gament |n[r|es 2496
lncldence 2496
AnaLomy 2497
8lomechanlcs 2497
PlsLory and physlcal examlnaLlon 2497
1reaLmenL 2300
kecoosttoctloo fot ootetlot ctoclote llqomeot losofflcleocy
2301
kebobllltotloo oftet ootetlot ctoclote llqomeot
tecoosttoctloo 2321
kesolts of ootetlot ctoclote llqomeot tecoosttoctloo 2322
compllcotloos of ootetlot ctoclote llqomeot sotqety 2323

8evlslon anLerlor cruclaLe llgamenL surgery 2324
Ctoft selectloo 2323
1ecbolcol cooslJetotloos 2326

oster|or crc|ate ||gament 2327
AnaLomy 2327
8lomechanlcs 2328
1reaLmenL 2329
Attbtoscoplcolly olJeJ postetlot ctoclote llqomeot tecoosttoctloo
2346
compllcotloos of postetlot ctoclote llqomeot tecoosttoctloo 2346

1ramat|c d|s|ocat|ons 2346
ClasslflcaLlon 2347
LxamlnaLlon and radlographlc evaluaLlon 2347
vascular and nerve ln[urles 2347
CLher assoclaLed ln[urles 2349
1reaLmenL 2349
Ootcome of opetotlve tteotmeot of koee Jlslocotloos 2331

ynov|a| p||cae 2332
Art|c|ar cart||age |n[r|es 2333
1reaLmenL 2333

Csteochondr|t|s d|ssecans 2338
LLlology 2339
1reaLmenL 2360
xclsloo of loose boJles 2361
Ootcomes of tteotmeot of osteocbooJtltls Jlssecoos of tbe
koee 2362

CompllcaLlons 2363

D|sorders of the pate||a 2363
CsLeochondrlLls dlssecans of Lhe paLella 2363
uorsal defecL of Lhe paLella 2363
8lparLlLe paLella 2364
Chondromalacla of Lhe paLella 2363
closslflcotloo ooJ etloloqy 2367
1teotmeot 2367

xtraart|c|ar anky|os|s of the knee 2370
LxLraarLlcular ankylosls ln exLenslon 2370
LxLraarLlcular ankylosls ln flexlon 2374

Cpen wonds of the knee [o|nt 2373
Chapter 44 ho|der and |bow In[r|es
kobert n M|||er II
Ieffrey A D|abach

ho|der |n[r|es 2601
Cllnlcal presenLaLlon and physlcal examlnaLlon 2603
Neet lmploqemeot slqo ooJ lmploqemeot test 2603
nowkloskeooeJy test 2603
Iobe test 2606
lotetool tototloo teslstooce sttess test 2606
Cetbet sobcotocolJ lmploqemeot test 2606
Iobe opptebeoslootelocotloo test 2606
5peeJ test 2606
etqosoo slqo 2606
llftoff test 2607
8elly ptess test 2607
xtetool tototloo sttess test 2607
xtetool tototloo loq slqo 2607
utop slqo 2607
lotetool tototloo loq slqo 2607

lmaglng 2609
Speclflc dlsorders 2609
lmploqemeot syoJtome 2609
compllcotloos 2614

8oLaLor cuff Lear 2614
lottloltblckoess ooJ folltblckoess teots 2613
Mosslve ooJ lttepotoble teots 2619
compllcotloos 2624

8oLaLor cuff Lear arLhropaLhy 2624
Adheslve capsullLls 2623
ltlmoty ftozeo sboolJet 2623

Calclflc LendlnlLls 2627
cbtoooloqlcol ptoqtessloo 2627
5otqlcol tteotmeot 2628
CuadrllaLeral space syndrome 2630

Suprascapular nerve enLrapmenL 2631

|bow |n[r|es 2634
Llbow LenopaLhles 2634
lotetol eplcooJylltls 2634
MeJlol eplcooJylltls 2639

Llbow conLracLures 2641
PeLeroLoplc osslflcaLlon 2643
Chapter 4S kecrrent D|s|ocat|ons

arry h||||ps

ate||a 2633
Cllnlcal feaLures 2636
8adlographlc feaLures 2637
ConservaLlve LreaLmenL 2638
Acote potellot Jlslocotloo ot sobloxotloo 2638
lotellofemotol molollqomeot ooJ tecotteot potellot
sobloxotloo 2660

Surglcal LreaLmenL 2660
Acote potellot Jlslocotloo 2660
lotellofemotol molollqomeot ooJ tecotteot potellot
sobloxotloo 2661

n|p 2670
ternoc|av|c|ar [o|nt 2672
ho|der 2677
normal funcLlonal anaLomy 2677
aLhologlcal anaLomy 2679
ClasslflcaLlon 2680
PlsLory 2681
LxamlnaLlon uslng anesLheLlc and arLhroscopy 2684
AnLerlor lnsLablllLy of Lhe shoulder 2683
ltoceJotes fot folleJ tecoosttoctloos 2697
nlstotlcol sotqlcol ptoceJotes 2700

osLerlor lnsLablllLy of Lhe shoulder 2704
coosetvotlve tteotmeot 2703

ArLhroscoplc surgery 2717

|bow 2717
AnaLomy 2717
aLhophyslology 2718
ArLhroscopy 2720
uloot collotetol llqomeot tecoosttoctloo 2721
Chapter 46 1ramat|c D|sorders

Ireder|ck M Azar

Compartment syndrome 2737
aLhophyslology 2737
AcuLe comparLmenL syndrome 2738
Chronlc exerLlonal comparLmenL syndrome 2743

kptre of msc|es and tendons 2747
Achllles Lendon ln[urles 2748
tloloqy 2748
lotbopbysloloqy 2748
uloqoosls ooJ tteotmeot 2748

neglecLed rupLure of Lhe Achllles Lendon 2733
1endlnlLls of Lhe Achllles Lendon 2738
8upLure of Lhe gasLrocnemlus muscle 2739
8upLure of Lhe exLensor mechanlsm of Lhe knee 2739
AcuLe rupLure of Lhe paLellar Lendon 2739
neglecLed rupLure of Lhe paLellar Lendon 2762
AcuLe rupLure of Lhe Lendon of Lhe quadrlceps femorls
muscle 2766
neglecLed rupLure of Lhe Lendon of Lhe quadrlceps femorls
muscle 2768
CompllcaLlons of Cuadrlceps 1endon 8upLure 2769
1endlnlLls or Lendlnosls of Lhe exLensor mechanlsm
([umpers knee) 2769
oJstoqe Jlstoptloo of tbe exteosot mecboolsm 2770

8upLure of Lhe adducLor longus muscle 2772
8upLure of Lhe blceps brachll muscle or lLs Lendons 2772
8upLure of Lhe pecLoralls ma[or muscle 2776
8upLure or avulslon of Lhe Lrlceps Lendon 2776

nern|as of the msc|es 2777
D|sp|acement of tendons 2778
eroneal Lendons 2778
8lceps brachll Lendon 2780
osLerlor Llblal Lendon dlslocaLlon 2782
art kIV Ak1nkCCC

Chapter 47 Genera| r|nc|p|es of Arthroscopy
Ireder|ck M Azar

Instrments and eq|pment 2789
ArLhroscope 2789
llberopLlc llghL sources 2791
1elevlslon cameras 2791
Accessory lnsLrumenLs 2791
ltobe 2791
5clssots 2792
8osket fotceps 2792
Ctosploq fotceps 2792
kolfe bloJes 2793
MototlzeJ sbovloq systems 2793
lecttosotqlcol loset ooJ toJloftepoeocy losttomeots
2793
lmploots 2794
Mlscellooeoos epolpmeot 2794

Care and sLerlllzaLlon of lnsLrumenLs 2794
lrrlgaLlon sysLems 2793
1ournlqueL 2799
Leg holders 2799

Anesthes|a 2800
Docmentat|on 2801
Advantages 2801
D|sadvantages 2802
Ind|cat|ons and contra|nd|cat|ons 2802
as|c arthroscop|c techn|qes 2802
1rlangulaLlon Lechnlque 2803

Comp||cat|ons 2803
uamage Lo lnLraarLlcular sLrucLures 2804
uamage Lo menlscl and faL pad 2804
uamage Lo cruclaLe llgamenLs 2803
uamage Lo exLraarLlcular sLrucLures 2803
8looJ vessels 2803
Netves 2803
llqomeots ooJ teoJoos 2806

PemarLhrosls 2806
1hrombophleblLls 2806
lnfecLlon 2807
1ournlqueL paresls 2807
Synovlal hernlaLlon and flsLulas 2807
lnsLrumenL breakage 2807
Chapter 48 Arthroscopy of the Lower xtrem|ty

arry h||||ps

nee 2811
8aslc dlagnosLlc Lechnlques 2812
Ceoetol ptloclples 2812
lotleot posltlooloq 2813
lottol plocemeot 2813
losettloo of scope 2816

ArLhroscoplc examlnaLlon of Lhe knee 2817
5optopotellot poocb ooJ potellofemotol jolot 2817
MeJlol qottet 2817
MeJlol compottmeot 2817
lotetcooJylot ootcb 2820
lostetomeJlol compottmeot 2821
lotetol compottmeot 2821
lotetol qottet ooJ postetolotetol compottmeot 2822

ArLhroscoplc surgery of Lhe menlscus 2823
closslflcotloo of meolscol teots 2823
1ypes of meolscol exclsloos 2824
Ceoetol ptloclples 2823
5otqety fot speclflc meolscol teots 2823
ulscolJ lotetol meolscos 2830
Meolscol cyst 2831
Attbtoscoplc tepolt of toto meolscl 2832

ArLhroscoplc surgery for oLher dlsorders 2843
loose boJles lo tbe koee jolot 2843
5yoovlol pllcoe of tbe koee 2846
OsteocbooJtltls Jlssecoos of tbe femotol cooJyles ooJ
potello 2848
ctoclote llqomeot tecoosttoctloo 2833
cbooJtomoloclo of tbe potello syoJtome 2886

CLher appllcaLlons of arLhroscopy of Lhe knee 2891
Attbtoscopy lo ftoctotes otoooJ tbe koee 2891
Attbtoflbtosls 2892
volootloo befote ptoxlmol tlblol osteotomles 2892
ubtlJemeot of osteoottbtosls ooJ obtosloo ottbtoplosty
2893

CompllcaLlons 2893

Ank|e 2894
ArLhroscoplc porLal placemenL and examlnaLlon 2894
Aotetlot pottols 2894
lostetlot pottols 2894
1toosmolleolot pottols 2893

SofLLlssue procedures 2898
5yoovectomy 2899
ubtlJemeot fot septlc ottbtltls 2899
kecoosttoctloo fot llqomeotoos ookle lojotles 2899

8ony procedures 2900
utlllloq exclsloo plooloq ot osteocbooJtol ttoosfet fot
osteocbooJtltls Jlssecoos ooJ ttoomotlc cbooJtol lesloos
2900
kemovol of osteopbytes fot ootetlot lmploqemeot
syoJtome 2901
Aokle ottbtoJesls 2901

ArLhroscopy of Lhe subLalar [olnL 2904
CompllcaLlons 2904

n|p 2903
lndlcaLlons 2903
Ceneral seLup 2903
Labral ln[urles 2909
CompllcaLlons 2911
Chapter 49 Arthroscopy of the Upper xtrem|ty

arry h||||ps

ho|der 2923
lndlcaLlons 2924
aLlenL poslLlonlng and anesLhesla 2924
lotetol Jecobltos posltloo 2924
8eocbcbolt posltloo 2926

ConLrol of bleedlng durlng arLhroscopy 2926
lluld exLravasaLlon 2927
orLal placemenL 2927
lostetlot pottol 2927
lostetolofetlot pottol 2928
Aotetlot pottol 2928
Aotetolofetlot pottol 2929
5opetlot pottol 2930
lotetol postetolotetol ooJ ootetolotetol pottols 2930

ulagnosLlc arLhroscopy and arLhroscoplc anaLomy 2930
Speclflc arLhroscoplc surglcal procedures 2934
kemovol of loose boJles 2934
5yoovectomy 2934
utolooqe ooJ JbtlJemeot 2933
kepolt of lobtol teots 2933
kepolt of blceps teoJoo lesloos 2942
kecoosttoctloo fot ootetlot lostoblllty 2949
lostetlot sboolJet stoblllzotloo 2939
lmploqemeot syoJtome 2964
lmploqemeot ooJ os octomlole 2966
lottlol tototot coff teots 2968
uelomlootloo teots ooJ locollzeJ pottloltblckoess
ottlcolotslJe tototot coff teots 2969
complete tototot coff teots 2976
Mosslve coottocteJ tototot coff teots 2983
5obscopolotls teoJoo teots 2983
Actomloclovlcolot jolot 2988
colclflc teoJloltls of tbe tototot coff 2990
Attbtoscoplc JbtlJemeot fot osteoottbtltls 2990
lostetlot osslflcotloo of tbe sboolJet (8eooett lesloo) 2991
5plooqleoolJ cyst 2991
Attbtoscoplc copsolot teleose 2991

CompllcaLlons 2993

|bow 2993
lndlcaLlons 2993
aLlenL poslLlonlng and anesLhesla 2993
5oploe posltloo 2994
ltooe posltloo 2994
lotetol Jecobltos posltloo 2993

orLal placemenL 2996
ArLhroscoplc examlnaLlon of Lhe elbow 2997
Speclflc arLhroscoplc surglcal procedures 3000
kemovol of loose boJles 3000
loooet Jlseose ooJ osteocbooJtltls Jlssecoos 3000
1btowloq lojotles 3003
volootloo of oloot collotetol llqomeot fooctloo 3003
lostetlot elbow lmploqemeot 3003
koJlol beoJ tesectloo 3003
Attbtoscoplc tteotmeot fot ottbtoflbtosls 3004
Attbtoscoplc JbtlJemeot fot osteoottbtltls 3006
5yoovectomy 3006
1eools elbow teleose 3006
Olectoooo botsltls 3007
AttbtoscoplcosslsteJ lottoottlcolot ftoctote cote 3007
lyottbtosls 3007

CompllcaLlons 3007

Wr|st 3008
art kV IkAC1Uk AND DILCCA1ICN

Chapter S0 Genera| r|nc|p|es of Iractre 1reatment
George W Wood II

C|ass|f|cat|on of fractres 3018
C|ass|f|cat|on of softt|sse |n[r|es 3020
1rama pr|nc|p|es 3021
Cpen fracLures 3023
Opeo ftoctotes cooseJ by flteotms 3023
Ampototloo vetsos llmb solvoqe 3028
Aotlblotlc tteotmeot 3030

1reaLmenL of sofLLlssue ln[urles 3032
uebrldemenL 3033
lttlqotloo ooJ JbtlJemeot of opeo woooJs 3037

1reaLmenL of bone ln[urles 3038
ltoctote stoblllzotloo 3038

Iractre hea||ng (bone regenerat|on) 3039
SLlmulaLlon of fracLure heallng 3041
8ooe qtoftloq 3041
lecttlcol ooJ olttosoooJ stlmolotloo 3044
loctots tbot oeqotlvely offect booe beolloq 3043

r|nc|p|es of srg|ca| treatment 3043
Ceneral lndlcaLlons for surglcal reducLlon and sLablllzaLlon 3043
ConLralndlcaLlons Lo surglcal reducLlon and sLablllzaLlon 3046
ulsadvanLages of surglcal reducLlon and sLablllzaLlon 3046
1lmlng of operaLlve LreaLmenL 3047
LamboLLes prlnclples of surglcal LreaLmenL of fracLures 3047

|omater|a|s of fractre f|xat|on 3048
MeLals 3048
8loabsorbable maLerlals 3048
compllcotloos 3049

|omechan|cs of |mp|ant des|gn and fractre f|xat|on 3030
ln and wlre flxaLlon 3030
Screw flxaLlon 3031
Mocbloe sctews 3032
A5ll sctews 3032
5ctew flxotloo tecbolpoes 3033

laLe and screw flxaLlon 3033
lockloq plotes 3039

lnLramedullary nall flxaLlon 3060
1ypes of lottomeJolloty oolls 3061
keomeJ vetsos ooteomeJ lottomeJolloty oollloq 3063

LxLernal flxaLlon 3063
xtetool flxotloo Jevlces 3063
AJvootoqes of extetool flxotloo 3064
ulsoJvootoqes of extetool flxotloo 3064
compllcotloos 3063
loJlcotloos 3066
ueslqo ooJ oppllcotloo of extetool flxotots 3067

kehab|||tat|on 3072
1reatment of comp||cat|ons from srg|ca| treatment of fractres 3072
lnfecLlon 3072
Cas gangrene 3073
1eLanus 3074
SofLLlssue compllcaLlons 3074
1hromboembollc compllcaLlons 3073
8lomechanlcal consLrucL compllcaLlons 3073
Chapter S1 Iractres of the Lower xtrem|ty

A a|ge Wh|tt|e

Ank|e 3086
ClasslflcaLlon 3086
lsolaLed fracLures of Lhe medlal and laLeral malleoll 3087
MeJlol molleolos 3087
lotetol molleolos 3089

8lmalleolar fracLure 3089
SyndesmoLlc ln[ury 3090
uelLold llgamenL Lear and laLeral malleolar fracLure 3094
lrreduclble fracLure or fracLuredlslocaLlon 3096
1rlmalleolar (CoLLon) fracLure 3096
lracLure of Lhe anLerlor Llblal margln aL Lhe ankle [olnL 3099
Ankle fracLures ln paLlenLs wlLh dlabeLes 3100
Cpen ankle fracLures 3100
unsLable fracLuredlslocaLlon when open reducLlon ls
conLralndlcaLed 3101
1lblal pllon fracLure 3101
Opeo teJoctloo ooJ plote flxotloo 3104
1wostoqe JeloyeJ opeo teJoctloo ooJ lotetool flxotloo
3103
combloeJ extetool ooJ llmlteJ lotetool flxotloo 3111
xtetool flxotloo ooJ flbolot plotloq 3111
ltlmoty ottbtoJesls 3117

1|b|a| shaft 3117
CasL braclng 3119
lnLramedullary flxaLlon 3120
keomeJ vetsos ooteomeJ oollloq 3121
ltoctotes of tbe ptoxlmol tbltJ of tbe tlblol sboft 3123
ltoctotes of tbe Jlstol tlblol sboft 3123
Aotetlot koee polo oftet lottomeJolloty oollloq 3123

Cpen Llblal shafL fracLure 3127
Mangled exLremlLy 3128
1echnlques of exLernal flxaLlon 3129
lns and plasLer for an unsLable Llblal shafL fracLure 3139
1ransflxaLlon by screws (ASll) 3139
1reaLmenL of delayed unlon 3146
llxaLlon of Lhe flbula for Llblal fracLure 3146
ueformlLles of Lhe fooL and Loes afLer Llblal fracLure 3146

1|b|a| p|atea fractre 3146
lracLure classlflcaLlon (SchaLzker) 3147
lracLuredlslocaLlon classlflcaLlon (Pohl and Moore) 3148
LvaluaLlon 3131
1reaLmenL 3131
ltoctote of tbe lotetol cooJyle 3133
llqomeot lojoty wltb cooJylot ftoctote 3137
Attbtoscoplcolly osslsteJ teJoctloo ooJ flxotloo of tlblol
ploteoo ftoctotes 3137
ltoctote of tbe meJlol cooJyle 3138
commlooteJ ptoxlmol ftoctotes 3139

CsLeochondral auLografLs for commlnuLed laLeral Llblal
condylar fracLures 3161

ate||a 3161
1reaLmenL 3162
CommlnuLed paLellar fracLures 3168

Csteochondra| knee fractre 3169
D|sta| femr 3170
uynamlc condylar screw flxaLlon 3173
lnLramedullary nalllng 3173
Condylar fracLure of Lhe femur 3177
uolcooJylot ftoctote of tbe femot 3177
lotetcooJylot ftoctotes of tbe femot 3179

Supracondylar fracLures of Lhe femur 3187

haft of the femr 3190
1racLlon and casL lmmoblllzaLlon 3190
llxaLlon wlLh plaLes and screws 3191
llxaLlon wlLh lnLramedullary nalls 3193
Opeo lottomeJolloty oollloq 3197
closeJ lottomeJolloty oollloq 3198
lotetlockloq lottomeJolloty (kossell1oylot) oollloq 3198
AoteqtoJe femotol oollloq (1tlqeo) 3204
kettoqtoJe oollloq of tbe femot 3207
lemotol oollloq wltboot ose of o ftoctote toble 3208
ttots ooJ compllcotloos of lottomeJolloty flxotloo 3209
lottomeJolloty flxotloo lo potboloqlcol ftoctotes 3213

SubLrochanLerlc fracLure of Lhe femoral shafL 3214
lracLure of Lhe femoral shafL wlLh dlslocaLlon of Lhe hlp
3214
lracLure of Lhe femoral shafL wlLh a femoral head
prosLhesls 3213
lracLure of Lhe femoral shafL and neck 3216
Chapter S2 Iractres and D|s|ocat|ons of the n|p

Dav|d G LaVe||e

n|p fractres 3237
lnLerLrochanLerlc femoral fracLures 3239
closslflcotloo 3239

SubLrochanLerlc femoral fracLures 3262
closslflcotloo 3262
1teotmeot 3263

lracLures of Lhe femoral neck 3271
ltoctote flxotloo 3271
closslflcotloo 3274
1teotmeot 3276
lollotes oftet lotetool flxotloo of tbe blp 3282
5ttess ftoctotes of tbe femotol oeck 3283
lotboloqlcol ftoctotes of tbe femotol oeck 3283
lostlttoJlotloo ftoctotes of tbe femotol oeck 3284

lracLures of Lhe femoral neck wlLh lpsllaLeral femoral shafL
fracLures 3283

D|s|ocat|on and fractred|s|ocat|on of the h|p 3286
osLerlor dlslocaLlon and fracLuredlslocaLlon 3287
1ype l postetlot Jlslocotloo 3287
1ype ll lll ot lv postetlot Jlslocotloo 3291
1ype v postetlot ftoctoteJlslocotloo wltb femotol beoJ
ftoctote 3291
lostetlot Jlslocotloo of tbe blp wltb ftoctote of tbe
femotol oeck ot sboft 3293

AnLerlor dlslocaLlon of Lhe hlp 3296
rognosls and compllcaLlons 3296
Chapter S3 Iractres of Acetab|m and e|v|s

Iames L Gyton
dward A erez

Acetab|ar fractres 3309
lnlLlal LreaLmenL 3309
AnaLomy 3311
ClasslflcaLlon 3316
1reaLmenL 3318
loJlcotloos fot oooopetotlve tteotmeot 3318
loJlcotloos fot opetotlve tteotmeot 3322
1lmloq of sotqety 3323
cbolce of sotqlcol opptoocb 3323

1reaLmenL of speclflc fracLure paLLerns 3323
lostetlot woll ftoctotes 3324
lostetlot colomo ftoctotes 3324
Aotetlot woll ooJ ootetlot colomo ftoctotes 3327
1toosvetse ftoctotes 3327
lostetlot colomo ftoctote wltb ossocloteJ postetlot woll
ftoctote 3328
1toosvetse ftoctote wltb ossocloteJ postetlot woll ftoctote
3329
1type ftoctotes 3329
Aotetlot colomopostetlot bemlttoosvetse ftoctotes 3329
8otbcolomo ftoctotes 3329

osLoperaLlve care 3330
CuLcome and compllcaLlons 3330
1oLal hlp arLhroplasLy as LreaLmenL for aceLabular fracLure
3334

e|v|c fractres 3334
lnlLlal managemenL 3333
AnaLomy 3338
ClasslflcaLlon 3338
lnlLlal LreaLmenL 3348
1reaLmenL reconsLrucLlve phase 3332
Chapter S4 Iractres of the ho|der Arm and Iorearm

Andrew n Crenshaw Ir
dward A erez

C|av|c|e 3371
Iractres arond the sho|der 3376
lracLures of Lhe scapula 3376
lracLures and fracLuredlslocaLlons of Lhe shoulder 3376
roxlmal humeral fracLures 3377
closslflcotloo 3378
koJloqtopblc evolootloo 3378
compllcotloos of ptoxlmol bometol ftoctotes 3388

Iractres of the hmera| shaft 3389
laLe osLeosynLhesls 3390
lmploot cbolce 3390
Apptoocb 3391
lostopetotlve cote 3391
compllcotloos 3391

lracLures of Lhe humeral shafL wlLh radlal nerve palsy 3397
erlprosLheLlc humeral shafL fracLures 3398

D|sta| hmera| fractres 3400
osLerlor fracLuredlslocaLlons of Lhe elbow 3408
Neotovoscolot lojotles 3408
1teotmeot 3409
compllcotloos 3410

kad|s and |na 3410
lracLures of Lhe olecranon 3410
llote flxotloo 3414

Clecranon fracLuredlslocaLlons 3413
lracLures of Lhe radlal head ln adulLs 3417
lracLures of Lhe radlal neck 3419
lracLures of Lhe radlal head or neck wlLh dlslocaLlon of Lhe
dlsLal radloulnar [olnL (LssexLopresLl fracLuredlslocaLlon)
3420
lracLures of Lhe proxlmal Lhlrd of Lhe ulna wlLh dlslocaLlon
of Lhe radlal head (MonLeggla fracLuredlslocaLlon) 3420
lracLures of Lhe dlsLal Lhlrd of Lhe radlus wlLh dlslocaLlon of
Lhe dlsLal radloulnar [olnL (Caleazzl fracLuredlslocaLlon)
3423
lracLures of Lhe shafL of Lhe radlus and ulna ln adulLs 3423
lotetool flxotloo 3428

Cpen fracLures of Lhe forearm 3441

Iractres of the d|sta| rad|s 3441
volar and dorsal 8arLon fracLures of Lhe dlsLal radlus 3446
Chapter SS Ma|n|ted Iractres
A a|ge Wh|tt|e

Ioot 3463
halanges of Lhe Loes 3463
MeLaLarsals 3463
1arsals 3463
1alus 3464
Molooloo of tbe oeck 3464
Molooloo of tbe boJy 3464
Calcaneus 3464

Ank|e 3471
ArLhrodesls for malunlLed fracLures of Lhe ankle 3476

Leg 3476
ShafLs of Lhe Llbla and flbula 3476
Condyles of Lhe Llbla 3482
lovetteJ ftoctotes of tbe tlblol cooJyles 3484
ltoctote of tbe lotetcooJylot emloeoce of tbe tlblo 3484

ate||a 3484
Iemr and h|p 3484
Condyles of Lhe femur 3484
lotetol femotol cooJyle 3484
MeJlol femotol cooJyle 3483
8otb femotol cooJyles 3483

lemoral shafL 3483
lemotol molooloo lo cbllJteo 3490

1rochanLerlc reglon of Lhe femur 3491
5obttocbootetlc osteotomy fot coxo voto ooJ tototloool
Jefotmltles 3492

CervlcoLrochanLerlc reglon of Lhe femur 3492

e|v|s 3493
1hreesLage reconsLrucLlon for pelvlc malunlons 3494

C|av|c|e 3493
MldshafL malunlons of Lhe clavlcle 3496

nmers 3496
LvaluaLlon 3499
1reaLmenL 3300
AnaLomlcal neck 3301
Surglcal neck 3301
roxlmal Lhlrd 3302
Mlddle Lhlrd 3302
ulsLal humerus 3303

Iorearm 3303
roxlmal Lhlrd of Lhe radlus and ulna 3303
koJlol beoJ 3303
koJlol oeck 3303
Olectoooo 3304
ltoxlmol tbltJ of tbe oloo wltb ootetlot Jlslocotloo of tbe
toJlol beoJ (Mooteqqlo ftoctote) 3304
5yoostosls betweeo tbe toJlos ooJ tbe oloo 3304

ShafLs of Lhe radlus and ulna ln adulLs 3306
loteotm molooloos wltb Jlstol toJlooloot jolot lostoblllty
3308
5boft of tbe oloo 3309

D|sta| rad|s 3309
LxLraarLlcular malunlon wlLh dorsal angulaLlon 3312
LxLraarLlcular malunlon wlLh volar angulaLlon 3314
lnLraarLlcular malunlons 3317
5olvoqe ptoceJotes 3319

ulsLal radloulnar [olnL lncongrulLy and arLhrosls 3320

Carps 3323
nand 3323
Chapter S6 De|ayed Un|on and Nonn|on of Iractres
ev|n C|eve|and

De|ayed n|on 3329
Nonn|on 3330
ConslderaLlons before surgery 3331
5totos of soft tlssoes ooJ oeotovoscolot sttoctotes 3331
5totos of booes 3331

Ceneral LreaLmenL of nonunlons 3332
keJoctloo of ftoqmeots 3333
8ooe qtoftloq 3333
5toblllzotloo of ftoqmeots 3338
lowloteoslty olttosoooJ 3339
lecttlcol ooJ electtomoqoetlc stlmolotloo 3339

lacLors compllcaLlng nonunlon 3339
lofectloo 3339
uefotmlty sbotteoloq ooJ seqmeotol booe loss 3342

Nonn|on of spec|f|c bones 3343
MeLaLarsals 3343
1lbla 3343
MeJlol molleolos 3343
1lblol sboft 3349

llbula 3333
lotetol molleolos 3333
llbolot sboft 3333

aLella 3333
lemur 3333
5optocooJylot oteo 3333
lemotol sboft 3334
1tocbootetlc ooJ sobttocbootetlc teqloo 3333
lemotol oeck 3333

elvls and aceLabulum 3338
Clavlcle 3338
Pumerus 3339
ltoxlmol tbltJ 3339
nometol sboft 3360
cooJyles 3362
ulstol bometos 3363

nonunlon of Lhe proxlmal Lhlrd of Lhe ulna wlLh dlslocaLlon
of Lhe radlal head (MonLeggla fracLure) 3363
lorearm bones 3364
8otb toJlos ooJ oloo 3364
koJlos ot oloo olooe 3364
ltoxlmol eoJ of tbe oloo 3363
ulstol eoJ of tbe oloo 3363

AmpuLaLlons 3363
Chapter S7 Acte D|s|ocat|ons

Ieffrey A D|abach

Ind|cat|ons for open redct|on 3373
Ank|e 3376
ate||a 3376
AcuLe dlslocaLlons of Lhe paLella 3376
lnLraarLlcular dlslocaLlons of Lhe paLella 3377

nee 3378
roxlmal Llbloflbular [olnL 3379

n|p 3381
ublc symphysls and sacrolllac [olnLs 3383

Acrom|oc|av|c|ar [o|nt 3386
LLlology and classlflcaLlon 3386
1reaLmenL 3387

ho|der 3392
|bow 3393
ulslocaLlon of Lhe radlal head 3393
ulslocotloo of tbe toJlol beoJ ooJ ftoctote of tbe ptoxlmol
tbltJ of tbe oloo (Mooteqqlo ftoctote) 3394
ltoctoteJlslocotloo of tbe elbow wltb sevete Jomoqe of
tbe soft sttoctotes 3394

ulsLal radloulnar [olnL 3393
Chapter S8 C|d Unredced D|s|ocat|ons

1erry Cana|e

Ioot 3603
Ank|e 3603
rox|ma| t|b|of|b|ar [o|nt 3604
nee 3604
ate||a 3606
n|p 3606
Chronlc unreduced (old) anLerlor dlslocaLlons 3606
Chronlc unreduced (old) posLerlor dlslocaLlons 3607

osLerlor dlslocaLlons 3609

Acrom|oc|av|c|ar [o|nt 3610
ho|der 3613
1reaLmenL 3614
closeJ teJoctloo 3613
Opeo teJoctloo 3616

AnLerlor dlslocaLlons 3616
osLerlor dlslocaLlons 3618
PemlarLhroplasLy 3621
1oLal shoulder arLhroplasLy 3621

|bow 3621
Closed reducLlon 3621
Cpen reducLlon 3622
Llbow arLhroplasLy 3630
AnLerlor dlslocaLlon of Lhe radlal head 3630
volume lv

art kVI kInkAL NkV INIUkI

Chapter S9 er|phera| Nerve In[r|es
Mark 1 Iobe
antos I Mart|nez

Anatomy of the sp|na| nerves 3636
ComponenLs of mlxed splnal nerves 3636
Motot 3636
5eosoty 3636
5ympotbetlc 3636

Cross anaLomy 3637
Mlcroscoplc anaLomy 3638

Interna| topography of per|phera| nerves 3639
Nerona| degenerat|on and regenerat|on 3639
C|ass|f|cat|on of nerve |n[r|es 3640
ffects of per|phera| nerve |n[r|es 3642
MoLor 3642
Sensory 3642
8eflex 3644
AuLonomlc 3644
8eflex sympaLheLlc dysLrophy 3644
1teotmeot 3643

t|o|ogy of per|phera| nerve |n[r|es 3646
C||n|ca| d|agnos|s of nerve |n[r|es 3647
ulagnosLlc LesLs 3647
lecttoJloqoostlc stoJles 3647
1loel slqo 3649
5weot test 3630
5klo teslstooce test 3630
lecttlcol stlmolotloo 3630

ar|y management of nerve |n[r|es 3630
Ceneral conslderaLlons of LreaLmenL 3630
lacLors LhaL lnfluence regeneraLlon afLer neurorrhaphy
3631
Aqe 3631
Cop betweeo oetve eoJs 3631
ueloy betweeo tlme of lojoty ooJ tepolt 3632
level of lojoty 3632
cooJltloo of oetve eoJs 3632

Ceneral conslderaLlons for surgery 3633
loJlcotloos 3633
1lme of sotqety 3633
losttomeots ooJ epolpmeot 3633
Aoestbeslo 3634
ltepototloo ooJ Jtoploq 3634

1echnlque of nerve repalr 3634
oJooeotolysls (lotetool oeotolysls) 3633
lottlol oeotottbopby 3633
Neotottbopby ooJ oetve qtoftloq 3636

Cerv|ca| p|exs 3661
Splnal accessory nerve 3661
1teotmeot 3662
kesolts of sotote of tbe splool occessoty oetve 3662

rach|a| p|exs 3662
LLlology and classlflcaLlon of brachlal plexus ln[urles 3663
ulagnosls of brachlal plexus ln[urles 3664
1reaLmenL of brachlal plexus ln[urles 3663
loJlcotloos fot sotqety 3663
5otqlcol qools 3666
comptebeoslve opptoocb to tbe btocblol plexos 3668
MetboJs of closloq qops 3669
kesolts of tteotmeot 3669

8rachlal plexus compresslon syndrome 3671
Suprascapular nerve 3671
xomlootloo 3671
1teotmeot 3671

Long Lhoraclc nerve 3672
Axlllary nerve 3672
xomlootloo 3673
1teotmeot 3673
kesolts oftet oxllloty oetve lojoty 3673
1eoJoo ooJ moscle ttoosfets fot potolysls of tbe JeltolJ
3674

MusculocuLaneous nerve 3674
xomlootloo 3674
1teotmeot 3674
kesolts oftet lojoty to tbe moscolocotooeoos oetve 3674

8adlal nerve 3674
xomlootloo 3673
1teotmeot 3673
kesolts of sotote of tbe toJlol oetve 3678
ctltlcol llmlt of Jeloy of sotote 3678

ulnar nerve 3678
xomlootloo 3678
1teotmeot 3679
kesolts of sotote of tbe oloot oetve 3680
Netve tecoosttoctloo 3681
1otJy oloot oetve polsy ooJ cobltol toooel syoJtome 3681

Medlan nerve 3683
xomlootloo 3683
1teotmeot 3683
kesolts of sotote of tbe meJloo oetve 3687

Lmbar p|exs 3688
lemoral nerve 3689
xomlootloo 3689
1teotmeot 3689
kesolts of sotote of tbe femotol oetve 3690

acra| p|exs 3690
SclaLlc nerve 3691
xomlootloo 3691
1teotmeot 3692
kesolts of sotote of tbe sclotlc oetve 3693

Common superflclal and deep peroneal nerves 3693
xomlootloo 3694
1teotmeot 3694
kesolts of sotote of tbe petooeol oetve 3693
1eoJoo ttoosfet fot petooeol oetve potolysls 3693

1lblal nerve 3693
xomlootloo 3696
Apptoocb to tbe tlblol oetve lo tbe popllteol fosso 3696
kesolts of sotote of tbe tlblol oetve 3697
art kVII MICkCUkGk

Chapter 60 M|crosrgery
Mark 1 Iobe

M|crovasc|ar techn|qes 3708
M|crosrg|ca| treatment of nerve |n[r|es 3711
rlmary neurorrhaphy 3711
lnLerfasclcular grafLlng 3713

kep|antat|on 3713
8esulLs 3716
8eplanLaLlon Leam 3717
Ceneral conslderaLlons 3717
lndlcaLlons 3718
Aqe 3718
5evetlty of lojoty 3718
level of lojoty ooJ pott ompototeJ 3718
wotm lscbemlo (oooxlc) tlme 3718

ConLralndlcaLlons 3719
Aqe 3719
5evetlty of lojoty 3720
level of lojoty 3720
wotm lscbemlo (oooxlc) tlme ooJ lmptopet ptesetvotloo
of pott 3720
lteexlstloq Jefotmlty ot Jlsoblllty 3720
Otbet cooJltloos tbot mlqbt ptecloJe teploototloo 3721

ManagemenL and LransporLaLlon of paLlenL and parL 3722
reoperaLlve preparaLlon 3722
Crder of repalr 3724
Moooqemeot of booes ooJ jolots 3724
1toosposltloo of Jlqlts 3723
1eoJoo tepolt 3723
vessel tepolt 3726

Ceneral afLerLreaLmenL 3728
ManagemenL of clrculaLory compromlse afLer replanLaLlon
3729
CLher compllcaLlons 3730
8ehablllLaLlon 3730
MonlLorlng Lechnlques afLer mlcrovascular surgery 3730

kevasc|ar|zat|on 3730
Speclal Lechnlques 3731

|ng|estage t|sse transfer (free f|aps) 3731
lndlcaLlons and advanLages 3732
ConLralndlcaLlons and dlsadvanLages 3733
SelecLlon of free flaps 3733
uppet exttemlty 3734
lowet exttemlty 3734

reoperaLlve requlremenLs 3734
Ceneral plan of procedure 3733
Ceneral afLerLreaLmenL 3736
MonlLorlng 3736
lree groln flap 3737
voscolot oootomy 3737

AnLerolaLeral Lhlgh flap 3740

Scapular and parascapular flap 3741

LaLeral arm flap 3743

Msc|e and msc|octaneos free f|aps 3744
LaLlsslmus dorsl Lransfer 3744

SerraLus anLerlor flap 3748

ecLoralls ma[or Lransfer 3749

1ensor fasclae laLae muscle flap 3731

Cracllls muscle Lransfer 3733

8ecLus abdomlnls Lransfer 3734

Inct|on|ng neromsc|ar transfers 3736

Iree vasc|ar|zed bone transp|ant 3739
lndlcaLlons 3761
reoperaLlve plannlng 3761
lree vascularlzed flbula Lransfer 3761

Compos|te free t|sse transfers from the foot 3768
neurovascular anaLomy 3768
uorsalls pedls flap 3770
llrsL web space pulp and hemlpulp neurovascular free flaps 3773
CreaL Loe wraparound flap 3773

1hmb and f|nger reconstrct|on 3779
SlnglesLage Lransfer of Lhe greaL Loe 3779
loJlcotloos 3779
lteopetotlve ploooloq 3779

Second and Lhlrd Loe LransplanLaLlon 3782
lteopetotlve ptepototloo 3783

Vasc|ar|zed free f|aps conta|n|ng [o|nts and ep|physes 3786
Vasc|ar|zed nerve grafts 3786
art kVIII 1n nAND

Chapter 61 as|c rg|ca| 1echn|qe and Aftercare
h||||p Wr|ght II

reoperat|ve p|ann|ng and preparat|on 3799
ArrangemenL and rouLlne ln Lhe operaLlng room 3800

Cho|ce of anesthes|a 3801
8rachlal plexus blocks 3802
lnLravenous reglonal anesLhesla 3802
erlpheral nerve blocks 3802
ulglLal nerve blocks 3803
Local lnfllLraLlon 3803

reparat|on and drap|ng for e|ect|ve srgery 3804
1orn|qet 3803
Instrments 3806
as|c sk|n techn|qe 3807
lnclslons 3807
lloqet loclsloos 3808
1bomb loclsloos 3810
lolmot loclsloos 3810

8aslc skln closure Lechnlques 3812
plosty 3813

Care after srgery 3813
p||nt|ng 3814
Chapter 62 Acte nand In[r|es
h||||p Wr|ght II

n|story 3821
I|rst a|d 3821
I|rst exam|nat|on 3822
AnesLhesla 3822
1ournlqueL 3822
Cleanslng and draplng of hand 3822
Second examlnaLlon 3823

Cons|derat|ons for amptat|on 3824
Crder of t|sse repa|r 3824
Arter|a| |n[r|es 3824
Cons|derat|ons for sk|n c|osre 3824
Methods and |nd|cat|ons for sk|n c|osre 3823
ulrecL suLure 3823
Skln grafLs 3823
Skln flaps 3823
Coverage of speclflc areas wlLh flaps 3826
ManagemenL of donor area 3826

Grafts and f|aps 3827
lree grafLs 3827
SpllLLhlckness skln grafLs 3827
Obtololoq sklo qtofts wltb o Jetmotome 3827

lree fullLhlckness grafLs 3829
Skln flaps 3829
Local flaps 3829
locol flops lo floqets 3832
locol flops ftom tbe Jotsom of tbe booJ 3833
ctoss floqet flops 3833

lorearm flaps for hand coverage 3837
koJlol foteotm flop 3837
lostetlot lotetosseoos flop 3839

Abdomlnal flaps 3840
kooJom potteto obJomlool peJlcle flops 3841
Axlol potteto flops 3842

lllleLed grafLs 3843

k|n coverage 3843
CranulaLlng areas 3843
Scars 3843
MetboJs of cottectloq lloeot scots 3846
MetboJs of cottectloq oteo scots 3846
Chapter 63 I|exor and xtensor 1endon In[r|es

h||||p Wr|ght II

I|exor tendons 3831
LxamlnaLlon 3832
8aslc Lendon Lechnlques 3834
5otote motetlol 3834
metqloq Jevlces ooJ tecbooloqles 3834
5otote cooflqototloos 3833

1lmlng of flexor Lendon repalr 3867
lottlol flexot teoJoo locetotloos 3867

rlmary flexor Lendon repalr 3868
2ooe l 3869
2ooe ll 3869
2ooe lll 3871
2ooe lv 3871
2ooe v 3871
ueloyeJ tepolt of ocote lojotles 3871
ltlmoty sotote of flexot teoJoos 3871

llexor Lendon ln[urles ln chlldren 3878
llexor Lendon rupLures 3879
1teotmeot 3879
losttepolt toptote 3880

8epalr of flexor Lendon of Lhumb 3881
2ooe l 3881
2ooe ll 3881
2ooe lll 3882
2ooe lv 3882
2ooe v 3882

Secondary repalr and reconsLrucLlon of flexor Lendons 3882
llexot teoJoos of floqets 3882
uooot teoJoos fot qtoftloq 3886
compllcotloos 3888
kecoosttoctloo of flexot teoJoo polleys 3889
kecoosttoctloo of floqet flexots by twostoqe teoJoo qtoft
3891
looq flexot of tbomb 3893
llexot teoolysls oftet tepolt ooJ qtoftloq 3897
AJbeteoce of teoJoos 3897

xtensor tendons 3899
AnaLomy 3899
LxamlnaLlon 3900
LxLensor Lendon repalr 3901
2ooe l 3902
2ooe ll 3903
2ooe lll 3903
2ooe lv 3909
2ooe v 3909
2ooe vl 3910
2ooe vll 3911
2ooe vlll 3911
2ooe l\ 3911

Secondary repalr of exLensor Lendons 3911
LxLensors of Lhe Lhumb 3912
2ooes 1l ooJ 1ll 3912
2ooes 1lll ooJ 1lv 3912
2ooe 1v 3912
Chapter 64 Iractres D|s|ocat|ons and L|gamentos In[r|es

Iames n Ca|andrcc|o
Mark 1 Iobe

r|nc|p|es of treatment 3922
Cpen fracLures and dlslocaLlons 3923
8aslc bone Lechnlques 3924

1hmb 3923
8enneLL fracLure 3923
compllcotloos 3927

8olando fracLure (commlnuLed flrsL meLacarpal base) and
oLher fracLures lnvolvlng Lhe flrsL carpomeLacarpal [olnL
3927
1humb carpomeLacarpal [olnL dlslocaLlon 3929
1humb meLacarpophalangeal fracLures and dlslocaLlons
3931
8upLure of Lhe Lhumb meLacarpophalangeal [olnL ulnar
collaLeral llgamenL 3933
kepolt of oo olJ oloot collotetol llqomeot toptote 3937

8adlal collaLeral llgamenL ln[urles 3939

Ior med|a| metacarpa|s 3940
CarpomeLacarpal fracLuredlslocaLlon of Lhe flnger rays
3940
lnLraarLlcular fracLure of Lhe base of Lhe flfLh meLacarpal
3940
llnger meLacarpophalangeal dlslocaLlons 3941
lracLure of Lhe meLacarpal shafL or neck 3944
MeLacarpal head fracLures 3947
MlolcooJylot plote flxotloo 3949

Wlrlng Lechnlques appllcable Lo long bone fracLures 3949

ha|anges 3949
lracLure of Lhe mlddle or proxlmal phalanx 3949
lracLuredlslocaLlon of Lhe proxlmal lnLerphalangeal [olnL 3931
lnLerphalangeal dlslocaLlons 3962
uostoble ptoxlmol lotetpbolooqeol jolot secooJoty to olJ collotetol
llqomeot toptote 3962
uoJloqooseJ lotetpbolooqeol Jlslocotloos 3963
ltoctote of tbe Jlstol pboloox 3966
Mollet floqet 3966

Intraart|c|ar fractres 3967
Comp||cat|ons of hand fractres 3969
Malunlon 3969
nonunlon 3973
ConLracLure 3974
Chapter 6S Nerve In[r|es

Mark 1 Iobe

va|at|on 3981
reoperaLlve assessmenL 3981
1ype of lojoty 3981
5eoslblllty 3982
Motot 3982
5oJomotot octlvlty 3983

osLoperaLlve assessmenL 3983
Motot testloq 3984
5objectlve evolootloo 3984
5oJomotot fooctloo 3984

Nerve regenerat|on 3984
r|mary and de|ayed pr|mary nerve repa|r 3983
1lmlng of repalr 3983
lndlcaLlons 3983

econdary nerve repa|r 3983
lndlcaLlons 3983
tr|ng of nerves 3986

Nerve grafts 3986
lndlcaLlons 3986
Sources of nerve grafLs 3987

Management of spec|f|c nerve |n[r|es 3989
ulglLal nerves 3989
ulnar nerve aL Lhe wrlsL 3991
ueep branch of Lhe ulnar nerve 3991
uorsal branch of Lhe ulnar nerve 3992
Medlan nerve aL Lhe wrlsL 3993
Medlan nerve ln Lhe palm 3993
Superflclal radlal nerve 3994

1ramat|c neromas 3994
Nerovasc|ar |s|and grafts 3994
Chapter 66 Wr|st D|sorders
h||||p Wr|ght II

Anatomy3999
ClrculaLlon 4001
8lomechanlcs and klnemaLlcs 4001

D|agnos|s of wr|st cond|t|ons 4003
PlsLory 4003
8adlographlc Lechnlques 4004
CLher dlagnosLlc Lechnlques 4003

Arthroscopy of the wr|st 4007
lndlcaLlons 4007
LqulpmenL 4008
oslLlonlng and preparaLlon of Lhe paLlenL 4008
Ceneral prlnclples 4008

Iractres and d|s|ocat|ons of the carpa| bones |nc|d|ng |enbck
d|sease 4012
lracLures of Lhe scaphold 4012
tloloqy 4012
Aootomy ooJ blooJ sopply of tbe scopbolJ booe 4012
uloqoosls ooJ tteotmeot 4013

navlculocaplLaLe fracLure syndrome and caplLaLe fracLures
4034
lracLures of oLher carpal bones 4033
lracLure of Lhe hamaLe 4033
1rapezlum and Lrapezold fracLures 4039
lracLures of Lhe lunaLe and klenbck dlsease 4040
Iolot levelloq ptoceJotes 4042
Osteotomles of tbe Jlstol toJlos 4042
looote tevoscolotlzotloo ptoceJotes 4042
ltostbetlc looote teplocemeot 4043

D|sta| rad|o|nar and |nocarpa| [o|nt |n[r|es 4044
AnaLomy 4044
ulagnosls and LreaLmenL 4043
lesloos of tbe ttlooqolot flbtocottlloqe complex locloJloq
ttoomotlc Jlstol toJlooloot jolot lostoblllty 4043
cbtoolc lostoblllty of tbe Jlstol toJlooloot jolot 4033

rocedures Lo sLablllze Lhe dlsLal radloulnar [olnL 4033
uloot lmpoctlooobotmeot ooJ Jlstol toJlooloot jolot
ottbtltls 4037

ulnar shorLenlng procedures 4061
ltoceJotes to stoblllze tbe oostoble ptoxlmol oloot seqmeot
oftet Jlstol oloot exclsloo 4066

ArLhrodesls of Lhe wrlsL 4070

Carpa| ||gament |n[r|es and |nstab|||ty patterns 4073
lnsLablllLy classlflcaLlon 4074
rogresslve perllunar lnsLablllLy 4073
8oLary subluxaLlon of Lhe scaphold 4073
AnLerlor dlslocaLlon of Lhe lunaLe 4076
almar Lransscaphold perllunar dlslocaLlons 4077
uorsal Lransscaphold perllunar dlslocaLlons 4077
1rlqueLrolunaLe and mldcarpal lnsLablllLles 4077
CLher lnsLablllLy paLLerns 4077
1reaLmenL opLlons for wrlsL llgamenL ln[urles and lnsLablllLy 4077
copsoloJesls 4083
llmlteJ wtlst ottbtoJesls 4086
Otbet llmlteJ wtlst ottbtoJeses 4088

Csteoarthr|t|s of the wr|st 4090
Chapter 67 pec|a| nand D|sorders
h||||p Wr|ght II

Anerysm thrombos|s and embo||sm |n rad|a| |nar and d|g|ta| arter|es 4103
1herma| brns 4106
|ectr|ca| brns 4111
kad|at|on brns 4112
Chem|ca| brns 4112
Irostb|te 4114
In[ect|on |n[r|es 4114
hotgn |n[r|es 4117
Wr|nger |n[r|es 4117
xtravasat|on |n[r|es 4117
sychof|exed and psychoextended hands (dysfnct|ona| postres) 4118
Iact|t|os hand syndromes 4119
Chapter 68 ara|yt|c nand
Iames n Ca|andrcc|o
Mark 1 Iobe

r|nc|p|es of tendon transfer 4126
lannlng Lendon Lransfer 4126
volootloq moscles fot teoJoo ttoosfet 4127
1lme of teoJoo ttoosfet 4127

1echnlcal conslderaLlons for Lendon Lransfer 4127

kestorat|on of p|nch 4128
8esLoraLlon of opposlLlon of Lhe Lhumb 4128
cottectloo of tbomb Jefotmlty 4129
1eoJoo ttoosfets to testote opposltloo 4129

8esLoraLlon of adducLlon of Lhe Lhumb 4133
8esLoraLlon of abducLlon of Lhe lndex flnger 4138

kestorat|on of |ntr|ns|c fnct|on of the f|ngers 4139
er|phera| nerve pa|s|es 4149
8adlal nerve palsy 4149
Low ulnar nerve palsy 4133
Plgh ulnar nerve palsy 4133
Low medlan nerve palsy 4133
Plgh medlan nerve palsy 4136
Comblned low medlan and ulnar nerve palsy (aL Lhe wrlsL) 4136
Comblned hlgh medlan and ulnar nerve palsy (above Lhe elbow) 4137

evere para|ys|s from damage to the cerv|ca| sp|na| cord or other
cases 4137
1eLraplegla 4137
closslflcotloo of tettopleqlo 4138
ltloclples of moooqemeot of tettopleqlo 4138
lbow exteosloo 4160
loteotm ptoootloo 4162
wtlst exteosloo 4162
key plocb 4162
Chapter 69 Cerebra| a|sy of the nand

Mark 1 Iobe

at|ent eva|at|on 4173
Nonoperat|ve management 4174
Cperat|ve management 4173
Coals 4173
rlnclples 4173
ronaLlon conLracLure of Lhe forearm 4176
llexlon deformlLles of Lhe wrlsL and flngers 4177
1humblnpalm deformlLy 4183
1teotmeot 4186

Swanneck deformlLy 4192
Chapter 70 Arthr|t|c nand

h||||p Wr|ght II

khemato|d arthr|t|s 4193
Csteoarthr|t|s 4197
ystem|c |ps erythematoss 4198
sor|at|c arthr|t|s 4198
ke|ter syndrome 4199
Got 4199
c|eroderma (progress|ve system|c sc|eros|s) 4200
Nonoperat|ve treatment for synov|t|s and tenosynov|t|s 4201
khemato|d nod|es 4201
tag|ng of operat|ons 4201
Use of |rschner w|res |n the rhemato|d hand 4202
I|nger deform|t|es cased by rhemato|d arthr|t|s 4202
lnLrlnslc plus deformlLy 4202
Swanneck deformlLy 4203
lottloslc teleose 4203

8uLLonhole or bouLonnlere deformlLy 4207
Attbtoplosty of tbe lotetpbolooqeol jolots 4209

ueformlLles of Lhe dlsLal [olnL 4211
uloot Jtlft ot Jevlotloo of tbe floqets 4211

LxLensor LenosynovlLls 4217

kptre of tendons 4217
LxLensor Lendon rupLure 4217
llexor Lendon rupLure 4218
erslsLenL synovlLls of Lhe proxlmal lnLerphalangeal [olnL 4218
llexor LenosynovlLls 4218
1enosynovlLls of Lhe flexor Lendon sheaLhs 4218
AttbtoJesls of tbe floqet jolots 4219
ulstol lotetpbolooqeol jolot ottbtoJesls 4221

Deform|t|es of the thmb 4222
ClasslflcaLlon of deformlLles 4222
1ype l 4222
1ype ll 4222
1ype lll 4222
1ype lv 4222

CsLeoarLhrlLls 4223
cottectloo of ottbtltlc tbomb Jefotmltles 4223
1topezlometocotpol ottbtoplosty 4230
AttbtoJesls of tbomb jolots 4241

khemato|d deform|t|es of the wr|st 4244
SynovlLls of Lhe wrlsL 4244
WrlsL arLhrodesls and arLhroplasLy 4248
Attbtoplosty 4230
Chapter 71 Compartment yndromes and Vo|kmann Contractre

Mark 1 Iobe

n|story 4239
Anatomy 4239
t|o|ogy 4260
D|agnos|s 4261
Management 4262
AcuLe comparLmenL syndrome of Lhe forearm 4262
LsLabllshed volkmann conLracLure of Lhe forearm 4263
Moscle sllJloq opetotloo of flexots fot estobllsbeJ volkmooo
coottoctote 4264

LsLabllshed lnLrlnslc muscle conLracLures of Lhe hand 4266
AdducLed Lhumb 4268
Chapter 72 Dpytren Contractre

Iames n Ca|andrcc|o

athogenes|s 4274
rognos|s 4276
1reatment 4277
Chapter 73 Carpa| 1nne| U|nar 1nne| and tenos|ng 1enosynov|t|s
h||||p Wr|ght II

Carpa| tnne| syndrome 4283
ulagnosls 4286
1reaLmenL 4287
5otqlcol teleose of cotpol toooel 4289
oJoscoplc teleose of cotpol toooel 4291

unrelleved or recurrenL carpal Lunnel syndrome 4298

U|nar tnne| syndrome 4298
tenos|ng tenosynov|t|s 4299
de Cuervaln dlsease 4299
1rlgger flnger and Lhumb 4300
8owler Lhumb 4304
Chapter 74 1mors and 1moros Cond|t|ons of the nand

Iames n Ca|andrcc|o
Mark 1 Iobe

C|ass|f|cat|on 4311
D|agnos|s 4312
1reatment 4312
en|gn tmors 4313
Llpoma 4313
lofllttotloq llpomos 4314
llpoblostomos 4314
lottooeotol llpoflbtomos 4314

ClanL cell Lumor of Lhe Lendon sheaLh (xanLhoma) 4313
8enlgn Lumors of flbrous orlgln 4316
kecottloq Jlqltol flbtoos tomot of cbllJbooJ 4316
Ioveolle opooeototlc flbtomo 4316
llbtomo 4316
Neotoflbtomo 4317

Clomus Lumor 4317
Pemangloma 4319
Lymphangloma 4319
neurllemoma (schwannoma) 4319
CsLeold osLeoma 4320
Lnchondroma 4320
8enlgn osLeoblasLoma 4321
Aneurysmal bone cysL 4321
ClanL cell Lumors of bone 4322
CsLeochondroma 4322
Synovlal chondromaLosls 4322

Ma||gnant tmors 4323
CsLeogenlc sarcoma 4326
Chondrosarcoma 4326
LplLhellold sarcoma 4327
Squamous cell carclnoma 4328
8asal cell carclnoma 4329
MallgnanL melanoma 4329
llbrosarcoma 4330
MeLasLaLlc Lumors 4330
8habdomyosarcoma 4330
Lwlng sarcoma 4330

1moros cond|t|ons 4330
Cangllon 4330
Lpldermold cysL (lncluslon cysL) 4333
Sebaceous cysL 4334
Mucous cysL 4334
CongenlLal arLerlovenous flsLula 4334
yogenlc granuloma 4336
lorelgn body granuloma 4336
CouL 4336
1raumaLlc neuroma 4336
ue[erlneSoLLas dlsease 4336
Calclnosls 4336
colcloosls cltcomsctlpto 4337

1urreL exosLosls 4337
CarpomeLacarpal boss 4338
Lpldermolysls bullosa 4338
ageL dlsease 4339
Chapter 7S nand Infect|ons

h||||p Wr|ght II

Iactors |nf|enc|ng hand |nfect|ons 4343
Genera| approach to hand |nfect|ons 4343
aronych|a 4347
Chronlc paronychla 4347

Ie|on 4348
bfasc|a| space |nfect|ons 4349
Web space |nfect|on (co||ar btton abscess) 4330
Deep fasc|a| space |nfect|ons 4330
SubaponeuroLlc space lnfecLlons 4331

1enosynov|t|s 4331
Infect|ons of rad|a| and |nar brsae 4334
I|nger [o|nt |nfect|ons (sept|c arthr|t|s) 4333
Csteomye||t|s 4336
nman b|te |n[r|es 4336
M|sce||aneos and nsa| |nfect|ons 4338
PerpeLlc lnfecLlons 4338
lnfecLlons ln drug addlcLs 4338
lnfecLlons ln paLlenLs wlLh acqulred lmmunodeflclency
syndrome 4338
necroLlzlng fascllLls 4338
Cas gangrene (closLrldlal myonecrosls) 4339
MycobacLerlal lnfecLlons 4360
1obetcolosls 4360
Nootobetcoloos mycoboctetlo 4360

lungal lnfecLlons 4361
yoderma gangrenosum 4361
Chapter 76 Congen|ta| Anoma||es of the nand

Mark 1 Iobe

r|nc|p|es of management 4367
Inc|dence and c|ass|f|cat|on 4368
mbryo|ogy 4369
Ia||re of format|on (arrest of deve|opment) 4369
1ransverse deflclencles 4369
ltostbetlc moooqemeot 4370

LonglLudlnal deflclencles 4374
lbocomello 4374
koJlol clobbooJtoJlol Jeflcleocles 4373
cleft booJceottol Jeflcleocles 4391
uloot clobbooJoloot Jeflcleocles 4400

Ia||re of d|fferent|at|on 4403
SyndacLyly 4403
1teotmeot 4404

AperL syndrome 4408
1teotmeot 4409

Dp||cat|on (po|ydacty|y) 4410
reaxlal polydacLyly (blfld Lhumb) 4410
1teotmeot 4411

1rlphalangeal Lhumb 4414
1teotmeot 4414

osLaxlal polydacLyly 4417
1teotmeot 4417

CenLral polydacLyly 4418
1teotmeot 4418

ulnar dlmella 4418
1teotmeot 4418

Cvergrowth (macrodacty|y) 4420
1reaLmenL 4422

Undergrowth 4424
PypoplasLlc Lhumb 4424
5bott tbomb 4424
AJJocteJ tbomb 4424
AbJocteJ tbomb 4428
llootloq tbomb (pooce flottoot) 4430
Abseot tbomb 4430
cooqeoltol clospeJ tbomb 4431

PypoplasLlc hands and dlglLs 4434

Congen|ta| r|ng syndrome 4438
1reaLmenL 4438

M|sce||aneos anoma||es 4440
CongenlLal Lrlgger dlglLs 4440
1teotmeot 4441

CampLodacLyly 4442
1teotmeot 4444

klrner deformlLy 4443
1teotmeot 4446

uelLa phalanx 4446
1teotmeot 4447

Madelung deformlLy 4448
1teotmeot 4449
art kIk 1n ICC1 AND ANL

Chapter 77 rg|ca| 1echn|qes
Greer k|chardson

rg|ca| techn|qes 4461
reoperaLlve preparaLlon 4461
1ournlqueL 4462
rophylacLlc anLlcoagulaLlon 4463
lnsLrumenLs 4463
AnesLhesla 4464
Chapter 78 D|sorders of the na||x
Greer k|chardson

na||x va|gs (bn|on) 4471
reoperaLlve managemenL 4471
SofLLlssue procedures 4476
Comblned sofLLlssue and bony procedures 4487
kellet tesectloo ottbtoplosty 4487

MeLaLarsal osLeoLomy 4493
CsLeoLomy of Lhe proxlmal flrsL meLaLarsal 4309
ltoxlmol ctesceotlc osteotomy wltb o Jlstol softtlssoe
ptoceJote 4310
ltoxlmol cbevtoo fltst metototsol osteotomy 4316

roxlmal phalangeal osLeoLomy 4322
ArLhrodesls of Lhe flrsL meLaLarsophalangeal [olnL for hallux
valgus 4326
!uvenlle and adolescenL hallux valgus (10 Lo 19 years old)
4333
Pallux valgus ln cerebral palsy 4340
CompllcaLlons afLer surgery for hallux valgus 4340
lteveotloq compllcotloos 4341
kecotteot Jefotmlty oftet slmple boolooectomy 4341
compllcotloos oftet cbevtoo osteotomy 4347
AcpolteJ bollox votos ooJ lottloslc mloos bollox 4349
compllcotloos of tesectloo ottbtoplosty of tbe fltst
metototsopbolooqeol jolot (kellet) 4362
compllcotloos oftet ottbtoJesls of tbe fltst
metototsopbolooqeol jolot 4363

na||x r|g|ds 4363

AttbtoJesls of tbe fltst metototsopbolooqeol jolot 4371
kesectloo ottbtoplosty (kellet ptoceJote) 4371

esamo|d |n[r|es of the ha||x 4372
1reaLmenL 4373
Chapter 79 es |ans
G Andrew Mrphy

I|ex|b|e pes p|ans 4387
1tlple ottbtoJesls 4394
lostetlot colcooeol Jlsplocemeot osteotomy 4397
Aotetlot colcooeol osteotomy 4398

Accessory nav|c|ar 4601
kldner procedure 4602

k|g|d pes p|ans 4604
1arsal coallLlon 4606
colcooeooovlcolot coolltloo 4608
1olocolcooeol coolltloo 4612

SubLalar arLhroerelsls 4618
Chapter 80 Lesser 1oe Abnorma||t|es

san N Ish|kawa
G Andrew Mrphy

Metatarsopha|angea| [o|nt |nstab|||ty 4623
LLlology 4623
ulagnosls 4626
1reaLmenL 4626
nammer toe and c|aw toe 4630

LLlology 4630
1reaLmenL 4631
5ofttlssoe ptoceJotes (CltJlestooe 1oylot lottlsb Mooo ooJ
cooqbllo) 4631
8ooe ooJ jolot ptoceJotes 4631

Ma||et toe 4640
LLlology 4640
1reaLmenL 4641

Comb|ned hammer toe and ma||et toe deform|ty w|th assoc|ated
dob|e corns 4644
Corns (he|omata and c|av|) 4644
LLlology and cllnlcal flndlngs 4644
1reaLmenL 4646
notJ coto 4646
5oft coto (lotetJlqltol coto) 4646
llootot coto (lottoctoble plootot ketotosls) 4648

n|onette (ta||ors bn|on) 4632
Ire|berg |nfract|on 4660
Chapter 81 khemato|d Ioot
Dav|d k k|chardson

Iorefoot 4668
1reaLmenL 4670
AttbtoJesls of tbe fltst metototsol 4684

M|dfoot 4684
llrsL meLaLarsalmedlal cunelform arLhrodesls 4684

n|ndfoot 4684
1reaLmenL 4684
1lblocolcooeol ooJ ookle ottbtoJeses 4692
Chapter 82 D|abet|c Ioot
san N Ish|kawa

D|abet|c |cer 4697
ClasslflcaLlon of dlabeLlc ulcers and dlagnosLlc alds 4697

Neropath|c |cer 4701
Ant|b|ot|c therapy 4703
I|xed deform|t|es |n the d|abet|c foot 4703
Neropath|c arthropathy 4703
Collapse paLLerns and sLaglng ln neuropaLhlc arLhropaLhy 4703
1reaLmenL 4703
Chapter 83 Nerogen|c D|sorders

Greer k|chardson

1arsa| tnne| syndrome 4717
AnaLomy and eLlology 4717
Cllnlcal flndlngs and dlagnosls 4717
1reaLmenL 4719

Anter|or tarsa| tnne| syndrome (deep peronea| nerve entrapment)
4721
Interd|g|ta| neroma (Morton toe) 4723
PlsLorlcal background 4723
aLhologlcal flndlngs 4723
1reaLmenL 4723

Cavs foot 4730
LLlology 4732
1reaLmenL 4733
clow toes 4733
lotefoot epoloos 4739
MlJfoot covos 4743
combloeJ covos (colcooeocovos Jefotmlty) 4747
colcooeocovovotos ooJ covovotos Jefotmlty 4748
colcooeocovovotos ooJ covovotos Jefotmlty ossocloteJ wltb
ottbtltlc cbooqes of tbe sobtolot ooJ mlJtotsol jolots 4732

mmary 4736
Chapter 84 D|sorders of Na||s and k|n
Greer k|chardson

Ingrown toena|| (onychocryptos|s ng|s |ncarnats) 4761
AnaLomy 4761
LLlology 4761
nonoperaLlve managemenL 4762
5toqe l (loflommototy stoqe) 4762
5toqe ll (obscess stoqe) 4762
5toqe lll (qtooolotloo stoqe) 4763

CperaLlve managemenL 4763

Dystroph|c na||s (onychogrypos|s onychomycos|s) 4776
Cther |es|ons of the na||s 4777
Subungual exosLosls 4777
Subungual and perlungual flbromas 4777
Clomus Lumor 4778
MallgnanL melanoma 4781
Chapter 8S D|sorders of 1endons and Iasc|a

G Andrew Mrphy

D|sorders of the poster|or t|b|a| tendon 4783
ulagnosls 4784
1reaLmenL 4788
5toqe l Jlseose (teoosyoovltls) 4788
5toqe ll Jlseose 4791
5toqe lll Jlseose 4797
losofflcleocy of postetlot tlblol teoJoo secooJoty to occessoty
oovlcolot 4797

D|sorders of the anter|or t|b|a| tendon 4799
ulagnosls 4799
1reaLmenL 4800
1eoosyoovltls 4800
complete toptote of teoJoo 4801

D|sorders of the peronea| tendons 4802
ulagnosls 4803
1reaLmenL 4803
letooeol teoJloltls 4803
letooeol teoJoo lostoblllty 4807
ulstol petooeol looqos teoJloltls ossocloteJ wltb os petooeom 4808
koptote of tbe petooeol teoJoos 4809

In[r|es of the f|exor tendons 4812
llexor hallucls longus LendlnlLls and lmplngemenL 4812
uloqoosls 4812
1teotmeot 4812

llexor hallucls longus Lear 4813
llexor dlglLorum longus Lendon 4814

a|nf| hee| 4813
LLlology 4813
1reaLmenL 4816
xttocotpoteol sbock wove tbetopy fot cbtoolc polofol beel
syoJtome 4817
5otqlcol moooqemeot of cbtoolc beel polo syoJtome 4817

Ach|||es tendon d|sorders 4822
nonoperaLlve managemenL of Achllles Lendon dlsorders
4822
lnserLlonal Achllles LendlnlLls 4823
uloqoosls 4823
1teotmeot 4823

Chronlc nonlnserLlonal Achllles Lendlnosls 4824

nag|nd deform|ty (pmp bmp) and retroca|canea| brs|t|s 4823
Chapter 86 Iractres and D|s|ocat|ons of the Ioot
G Andrew Mrphy

Iractres of the ca|canes 4833
Mechanlsm 4833
ClasslflcaLlon 4833
1reaLmenL 4836
ueclsloo mokloq lo colcooeol ftoctotes 4838
Opeo teJoctloo tecbolpoes 4839
1ooqoe ftoctote of tbe colcooeos 4846
compllcotloos ooJ pteveotloo 4847
kesolts 4848

1a|ar fractres 4831
AnaLomy 4831
1alar head fracLures 4833
1teotmeot 4833

1alar neck fracLures 4834
1teotmeot 4833
Osteooectosls of tbe tolot boJy oftet tolot oeck ftoctote
4838

1alar body fracLures 4861
lracLures of Lhe laLeral posLerlor or medlal process of Lhe
Lalus 4863
lotetol ptocess ftoctotes 4863
lostetlot ptocess ftoctotes 4864
MeJlol ptocess ftoctotes 4864

1ranschondral fracLures of Lhe Lalus 4866

bta|ar d|s|ocat|ons 4867
M|dfoot fractres and d|s|ocat|ons 4870
lracLuredlslocaLlons of Lhe LarsomeLaLarsal arLlculaLlon (Llsfranc [olnL)
4871
closslflcotloo 4873
volootloo ooJ tteotmeot 4873

Metatarsa|s 4877
lracLure of Lhe proxlmal porLlon of Lhe flfLh meLaLarsal
4877
ulsLal flfLh meLaLarsal fracLure 4884
SLress fracLure of Lhe meLaLarsals 4883
compllcotloos 4883

AcuLe fracLures of Lhe cenLral meLaLarsals 4883

ha|angea| d|s|ocat|ons 4887
lnLerphalangeal [olnL of Lhe hallux 4887
llrsL meLaLarsophalangeal [olnL 4888

ha|angea| fractres 4889
esamo|d fractres 4890
1reaLmenL 4891
CsLeochondrlLls of Lhe sesamold 4892
CLher condlLlons of Lhe sesamold 4892

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Chapter 1 rg|ca| 1echn|qes and Approaches

Chapter 2 Magnet|c kesonance Imag|ng |n Crthopaed|cs

Chapter 3 Arthrodes|s of the Ank|e nee and n|p

Chapter 7 Arthrop|asty of the n|p

lnfecLlous dlsorders 390

kev|s|on of tota| h|p arthrop|asty 430

ostoperat|ve management of tota| h|p arthrop|asty 464

Chapter 12 Amptat|ons of the n|p and e|v|s

Chapter 18 1berc|os|s and Cther Unsa| Infect|ons

Chapter 20 en|gn one 1mors and Nonneop|ast|c Cond|t|ons

Chapter 21 en|gn]Aggress|ve 1mors of one

art VII NCN1kAUMA1IC CI11IU DICkDk

Chapter 2S M|sce||aneos Nontramat|c D|sorders

Chapter 27 Congen|ta| and Deve|opmenta| Anoma||es of the n|p and

art k NkVCU 1M DICkDk IN CnILDkN

hyslologlcal classlflcaLlon 1336

Chapter 31 ara|yt|c D|sorders

Chapter 32 Neromsc|ar D|sorders

art kI IkAC1Uk AND DILCCA1ICN IN CnILDkN

Chapter 3S Iractres D|s|ocat|ons and IractreD|s|ocat|ons of the p|ne

Chapter 37 ed|atr|c Cerv|ca| p|ne

Cllnlcal flndlngs 1906

Chapter 39 Lower ack a|n and D|sorders of Intervertebra| D|scs

art kIII Ck1 MDICIN

Interna| derangements 2372

Chapter 43 nee In[r|es

CLher condlLlons of menlscl 2432

CuadrllaLeral space syndrome 2630

Chapter 4S kecrrent D|s|ocat|ons

Chapter 46 1ramat|c D|sorders

art kIV Ak1nkCCC

Chapter 48 Arthroscopy of the Lower xtrem|ty

Chapter 49 Arthroscopy of the Upper xtrem|ty

Chapter S1 Iractres of the Lower xtrem|ty

Chapter S2 Iractres and D|s|ocat|ons of the n|p

Chapter S3 Iractres of Acetab|m and e|v|s

Chapter S4 Iractres of the ho|der Arm and Iorearm

Chapter S7 Acte D|s|ocat|ons

Chapter S8 C|d Unredced D|s|ocat|ons

art kVII MICkCUkGk

Chapter 63 I|exor and xtensor 1endon In[r|es

Chapter 64 Iractres D|s|ocat|ons and L|gamentos In[r|es

Chapter 6S Nerve In[r|es

Chapter 69 Cerebra| a|sy of the nand

Chapter 70 Arthr|t|c nand

Chapter 71 Compartment yndromes and Vo|kmann Contractre

Chapter 72 Dpytren Contractre

Chapter 74 1mors and 1moros Cond|t|ons of the nand

Chapter 7S nand Infect|ons

Chapter 76 Congen|ta| Anoma||es of the nand

art kIk 1n ICC1 AND ANL

Chapter 80 Lesser 1oe Abnorma||t|es

nammer toe and c|aw toe 4630

Chapter 83 Nerogen|c D|sorders

Chapter 8S D|sorders of 1endons and Iasc|a

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